Document Detail


Reoperations on the aortic root: experience in 46 patients.
MedLine Citation:
PMID:  20103210     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The increasing use of biologic conduits and the advances in reparative aortic root procedures has increased the number of patients who may require reoperation on the aortic root. Although the primary operation yields excellent results with a low risk for morbidity and mortality, reoperation on the aortic root is still challenging. METHODS: We reviewed retrospectively our experience in 46 patients (38 men; mean age, 57 +/- 11 years) who underwent aortic root reoperations in the last 7 years. Of these, 42 had received prior aortic root replacement. The indications for reoperation included prosthesis infection in 16, false aneurysm in 16, and degenerative or postdissection aneurysm and valve prosthesis failure. Aortic root re-replacement was performed in 39 patients (85%) and closure of false aneurysm in 7. Univariate and multivariate analysis on 22 perioperative variables were performed. RESULTS: In-hospital mortality was 6.5% (3 patients). The postoperative course was complicated in 19 (41%). At multivariate analysis, perioperative myocardial infarction was a risk factor for hospital mortality (2 patients). Survival was 88% at 1 year and 74% at 5 years. No differences were found in survival according to redo indication. Freedom from reoperation on the aortic root was 100% at 1 year and 90% at 5 years. CONCLUSIONS: Reoperation on the aortic root can be performed with acceptable mortality and good midterm and long-term outcome; however, the postoperative complication rate is still high.
Authors:
Pietro G Malvindi; Bart P van Putte; Robin H Heijmen; Marc A A M Schepens; Wim J Morshuis
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  89     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-01-27     Completed Date:  2010-03-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  81-6     Citation Subset:  AIM; IM    
Copyright Information:
2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Cardiothoracic Surgery, St. Antonius Hospital, Nieuwegein, The Netherlands. pmalvin@tin.it
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aortic Diseases / mortality,  surgery*
Blood Vessel Prosthesis Implantation / methods*,  mortality
Female
Follow-Up Studies
Humans
Male
Middle Aged
Morbidity / trends
Netherlands / epidemiology
Postoperative Complications / epidemiology
Reoperation / mortality,  statistics & numerical data
Retrospective Studies
Survival Rate / trends
Time Factors
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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