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Reimplantation valve-sparing aortic root replacement for aortic root aneurysm in the elderly: are we pushing the limits?
MedLine Citation:
PMID:  19323705     Owner:  NLM     Status:  In-Process    
OBJECTIVES: Reimplantation valve-sparing aortic root replacement has been increasingly performed with improving perioperative and midterm results. However, extending the age criterion in patient selection remains a debate. This study reviews the results of reimplantation valve-sparing aortic replacement in patients greater than 60 years of age.
METHODS: During a 51-month period, 63 patients with aortic root aneurysms underwent reimplantation valve-sparing aortic root replacement. The Gelweave Valsalva prosthesis (TERUMO CardioVascular Systems Corp., Ann Arbor, MI, USA) was used in all but one case. The patients were predominantly male, and the mean age was 67 years (range, 61-83 years). Four patients had congenital bicuspid aortic valves, and cusp repair was required in one patient. The mean follow-up was 25 months (range, 1-51 months).
RESULTS: There were one hospital and two late deaths. Overall survival at 51 months was 84 +/- 9.9%. During follow-up, one patient developed severe aortic incompetence (AI) requiring an aortic valve replacement (AVR). Freedom from reoperation at 51 months was 92.8 +/- 6.8%. Moderate AI was present at latest echocardiogram in one patient. Freedom from moderate or severe AI at 51 months was 90 +/- 9.4%. There was no episode of endocarditis on follow-up. Univariate analysis demonstrated that no preoperative or intraoperative factor was a predictor for late reimplantation failure.
CONCLUSIONS: Reimplantation valve-sparing aortic root replacement in patients greater than 60 years old can be performed with satisfactory perioperative and midterm results. Long-term results are needed to define the durability of this technique and its role in this subset of patients.
Fabrizio Settepani; Wilson Y Szeto; Marcello Bergonzini; Alessandro Barbone; Enrico Citterio; Daniele Berwick; Roberto Gallotti; Joseph E Bavaria
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Publication Detail:
Type:  Journal Article     Date:  2009-03-23
Journal Detail:
Title:  Journal of cardiac surgery     Volume:  25     ISSN:  1540-8191     ISO Abbreviation:  J Card Surg     Publication Date:    2010 Jan-Feb
Date Detail:
Created Date:  2010-01-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8908809     Medline TA:  J Card Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  56-61     Citation Subset:  IM    
Cardiac Surgery Department, Istituto Clinico Humanitas, Rozzano, Italy.
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