Document Detail


Reoperations on the aortic valve combined with replacement of the ascending aorta.
MedLine Citation:
PMID:  12027127     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To review the experience with reoperations on the aortic valve combined with replacement of the ascending aorta. PATIENTS AND METHODS: From 1991 to 2000, 237 patients underwent reoperations on the aortic valve combined with replacement of the ascending aorta. The study consisted of 188 men and 49 women, with a mean age of 51 years. The operation was urgent or emergent in 44% of cases. Many patients (42%) were in New York Heart Association Class IV, and 24 had active infective endocarditis. The ascending aorta was replaced previously in 46 patients, while the remaining patients had aneurismal dilation. An aortic valve sparing operation was performed in 14 patients and aortic valve replacement in 223. The ascending aorta was replaced in all patients as follows: as a composite graft in 166 and supracoronary in 71. Mechanical valves were used in 145 (61%) patients. RESULTS: The operative mortality was 9%. Postoperative complications were common and 30% of patients suffered an adverse event (death or complication). No independent predictor of operative mortality could be identified but urgent/emergent surgery, advanced functional class, infective endocarditis, coronary artery disease, and replacement of the transverse aortic arch were associated with higher operative mortality by chi-square analysis. The survival at 5 years was 74%+/-4% for patients who had composite replacement of the aortic valve and ascending aorta. CONCLUSIONS: Reoperations on the aortic valve combined with replacement of the ascending aorta can be performed with acceptable operative risk and good mid-term survival.
Authors:
T E David
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of cardiac surgery     Volume:  17     ISSN:  0886-0440     ISO Abbreviation:  J Card Surg     Publication Date:    2002 Jan-Feb
Date Detail:
Created Date:  2002-05-24     Completed Date:  2002-06-14     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8908809     Medline TA:  J Card Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  46-50     Citation Subset:  IM    
Affiliation:
Division of Cardiovascular Surgery of Toronto General Hospital, University Health Network and the University of Toronto, Ontario, Canada. tirone.david@uhn.on.ca
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aorta / surgery*
Aortic Valve / surgery*
Coronary Artery Disease / mortality,  surgery
Endocarditis / etiology
Female
Follow-Up Studies
Heart Valve Prosthesis Implantation
Humans
Logistic Models
Male
Middle Aged
Ontario
Postoperative Complications / etiology
Recurrence
Reoperation
Survival Analysis
Treatment Outcome

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


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