Original articleAdult cardiacQuality of Life After Aortic Root Surgery: Reimplantation Technique Versus Composite Replacement
Section snippets
Patients and Methods
This study was approved by the Ethics Committee of the Friedrich-Schiller University. All patients were asked to participate at this study at time of the QoL survey.
From September 1999 to December 2005, a total of 143 consecutive patients underwent the aortic root operation. Two types of aortic root operations were performed. In the composite group, 67 patients received a total replacement of the aortic root using mechanical conduit prosthesis (CarboSeal; Sorin, Munchen, Germany). In the David
Clinical Outcome
Nine patients died during the hospital follow-up (6.3%), 6 after elective operation and 3 after acute aortic dissection repair. Consecutively, the hospital survival rates were recorded at 97.4% (74 of 76 patients) for the David group and 89.6% (60 of 67 patients) for the composite group (p = 0.102). Causes of death include bowel ischemia (2), systemic inflammatory response syndrome with consecutive multiple organ failure (2), severe stroke (2), and rupture of the descending aorta, cardiac low
Comment
Aortic valve-sparing operations have been developing rapidly over recent years. Reported hospital mortality ranges from 0% to approximately 10%, depending on incidence of acute type A aortic dissection, emergency, mean age, and Marfan's syndrome [3, 9, 10, 11, 12]. Correspondingly, 1-year survival rates of more than 90%, and 10-year survival rates of approximately 80%, can be achieved [3, 9, 12]. The longevity of reconstruction results are reported as extremely stable, offering a freedom from
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Cited by (36)
2022 ACC/AHA guideline for the diagnosis and management of aortic disease: A report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines
2023, Journal of Thoracic and Cardiovascular SurgeryLong-term outcomes after aortic root repair using selective sinus replacement
2023, Journal of Thoracic and Cardiovascular SurgeryCitation Excerpt :However, there is no doubt that the repair was performed, as always for every VSRR technique and every VSRR population, in selected patients, not only in regard to the aortic root anatomo-pathology but also in the acute dissection subpopulation in regard to the patients' clinical conditions and surgeon's experience.28 The low rate of observed AV-related events (in agreement with other studies reporting long-term results after VSRR2,5-8) may play a considerable role in the unchanged life expectancy. Selective sinus replacement offers excellent functional long-term results regardless of underlying root pathology or annulus size (Figure 5).
2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines
2022, Journal of the American College of CardiologyRegurgitant Bicuspid Aortopathy: Is Valve-Sparing Root Replacement Equivalent to Bentall Procedure?
2021, Annals of Thoracic SurgeryCitation Excerpt :Overall, VSRR offers the advantage of preserving the native valve and avoiding anticoagulation and is especially suitable for carefully selected patients. In young patients, VSRR has also been shown to provide improved quality of life over both mechanical and biological valve conduits.31 Given these advantages, we advocate for the application of VSRR in centers having robust aortic surgery programs and appropriate expertise to identify and treat patients with BAV and aortopathy who might be ideal candidates for this procedure.
David reimplantation with simultaneous total arch replacement and stented elephant trunk for acute type A aortic dissection
2021, Journal of Thoracic and Cardiovascular SurgeryCitation Excerpt :According to previous studies, long-term survival following David reimplantation in ATAAD is excellent, with satisfactory durability of the valve.11,19 David reimplantation also has comparable safety and efficacy compared with the Bentall procedure and results in good potential long-term outcomes because of preservation of the native valve and avoiding the need for anticoagulation therapy.8,24,25 In this study, overall survival and the incidence of valve-related events during follow-up were similar between the 2 groups.
Valve-Sparing Root Replacement Versus Composite Valve Grafting in Aortic Root Dilation: A Meta-Analysis
2020, Annals of Thoracic Surgery