Long-term survival, valve durability, and reoperation for 4 aortic root procedures combined with ascending aorta replacement

The Journal of Thoracic and Cardiovascular Surgery
Lars G SvenssonEugene H Blackstone

Abstract

To evaluate long-term results of aortic root procedures combined with ascending aorta replacement for aneurysms, using 4 surgical strategies. From January 1995 to January 2011, 957 patients underwent 1 of 4 aortic root procedures: valve preservation (remodeling or modified reimplantation, n = 261); composite biologic graft (n = 297); composite mechanical graft (n = 156); or allograft root (n = 243). Seven deaths occurred (0.73%), none after valve-preserving procedures, and 13 strokes (1.4%). Composite grafts exhibited higher gradients than allografts or valve preservation, but the latter 2 exhibited more aortic regurgitation (2.7% biologic and 0% mechanical composite grafts vs 24% valve-preserving and 19% allografts at 10 years). Within 2 to 5 years, valve preservation exhibited the least left ventricular hypertrophy, allograft replacement the greatest; however, valve preservation had the highest early risk of reoperation, allograft replacement the lowest. Patients receiving allografts had the highest risk of late reoperation (P < .05), and those receiving composite mechanical grafts and valve preservation had the lowest. Composite bioprosthesis patients had the highest risk of late death (57% at 15 years vs 14%-26% for the rem...Continue Reading

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Citations

Aug 9, 2016·The Journal of Thoracic and Cardiovascular Surgery·Kenton J Zehr
Dec 15, 2016·Journal of Cardiac Surgery·Salvior C M MokJohn A Elefteriades
May 10, 2017·Journal of Cardiac Surgery·Mario GaudinoUNKNOWN Cornell International Consortium for Aortic Surgery (CICAS)
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Apr 6, 2021·The Journal of Thoracic and Cardiovascular Surgery·Babatunde A YerokunG Chad Hughes
Sep 29, 2020·The Annals of Thoracic Surgery·James C WittenGösta B Pettersson
Apr 13, 2021·The Journal of Thoracic and Cardiovascular Surgery·Dawn S Hui, Andrea J Carpenter
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Dec 2, 2021·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Maria C PalumboJonathan W Weinsaft

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