High-Volume Practice by a Single Specialized Team Reduces Mortality and Morbidity of Elective and Urgent Aortic Root Replacement

Aorta : Official Journal of the Aortic Institute at Yale-New Haven Hospital
Gopal SoppaMarjan Jahangiri

Abstract

Elective aortic root replacement (ARR), or the Bentall procedure, is associated with significant mortality and complications. Recent studies have shown that high procedure volume has an inverse association with postoperative mortality. The outcomes of patients undergoing elective/urgent ARR by a single, high-volume surgical team were assessed in this study. Patients undergoing nonemergency, elective/urgent ARR for non-Marfan aortic root dilatation, from October 2005 to March 2011, were studied. Valve-preserving procedures, extra-anatomic bypass, and arch and descending aortic repairs were excluded. Patient demographics, operative details, and postoperative outcomes were collected prospectively. Surgical techniques included central cannulation and cardiopulmonary bypass (CPB) at 35°C. Following aneurysm excision, a composite valve-conduit reconstruction with coronary button reimplantation was performed. Tissue glue, Teflon pledgets, and blood products were seldom used. Patients were followed locally at 8 weeks, 6 months, and annually thereafter with echocardiography and computed tomographic (CT) scanning. From October 2005 to March 2011, 163 ARRs were performed. Of these, 131 (80%) were isolated first time procedures (four in pr...Continue Reading

Citations

Mar 16, 2017·Journal of the American Heart Association·Alex BottleUNKNOWN UK Aortic Forum

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