Early results of valve-sparing aortic root replacement in high-risk clinical scenarios

The Annals of Thoracic Surgery
Faraz KerendiEdward P Chen

Abstract

The feasibility of valve-sparing aortic root procedures (David) in certain high-risk situations has been questioned. We sought to determine the safety of the David procedure in the following high-risk subgroups: acute type A dissection, severe aortic insufficiency (AI), and reoperations. From 2005 through 2007, 110 root replacements were performed for the above criteria: 73 root replacements with a composite valve-conduit (Bentall) and 37 David procedures. The reimplantation technique was used in all 37 David patients, with 7 requiring aortic cusp repair. There were no significant differences in preoperative or intraoperative variables between the groups, with the exception of cross-clamp time, which was longer for David patients. There was a slight, but nonsignificant increase in mortality among Bentall patients (8.2% [6 of 73]) compared with David patients (5.4% [2 of 37], p = 0.59]. There were no differences with respect to postoperative stroke, renal failure, or respiratory failure. Predischarge echocardiogram in the surviving 35 David patients demonstrated no AI in 25 patients and trace/mild AI in 10. Freedom from AVR at a mean follow-up of 8.8 months (range, 1 to 40) was 94.3% (33 of 35). One patient required AVR because ...Continue Reading

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Citations

Jun 19, 2012·The Korean Journal of Thoracic and Cardiovascular Surgery·Ju Yong LimJae Won Lee
Jan 31, 2014·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Christine N H Tan, Alan G Fraser
Mar 19, 2014·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Manuel CaceresLars G Svensson
Jul 15, 2015·Scandinavian Cardiovascular Journal : SCJ·Heemoon LeeYoung Tak Lee
Oct 31, 2014·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Hitoshi MinamiYutaka Okita
Feb 15, 2012·The Journal of Thoracic and Cardiovascular Surgery·Bradley G LeshnowerEdward P Chen
Jun 18, 2014·The Journal of Thoracic and Cardiovascular Surgery·Sotiris C StamouNicholas T Kouchoukos
Apr 20, 2014·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·David R KoolbergenMark G Hazekamp
Sep 11, 2019·Interactive Cardiovascular and Thoracic Surgery·Mohammad Yousuf SalmasiThanos Athanasiou
Sep 2, 2011·Annals of Thoracic and Cardiovascular Surgery : Official Journal of the Association of Thoracic and Cardiovascular Surgeons of Asia·Hideyuki Shimizu, Ryohei Yozu
Aug 26, 2017·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Erik BeckmannMalakh Lal Shrestha
Oct 27, 2020·Proceedings·Mohanad HamandiWilliam T Brinkman
Jan 21, 2020·The Journal of Thoracic and Cardiovascular Surgery·Jun LiChunsheng Wang

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