BACKGROUND: The purpose of this study was to examine our experience with proximal aortic reoperations in patients with composite valve grafts (CVGs) and assess postoperative survival and morbidity. METHODS: Since 1991, 33 patients with CVGs underwent reoperation for one or more of the following indications: aneurysms distal to the CVG (n = 20, 61%), false aneurysms (n = 13, 39%) and graft infection (n = 7, 21%). Operations included false aneurysm repair (n = 13, 39%), graft replacement of distal ascending aortic or transverse aortic arch aneurysm (n = 20, 61%) and aortic root re-replacement with a new CVG (n = 6, 18%) or homograft (n = 4, 12%). RESULTS: Operative mortality was 15% (n = 5), including 2 of the 7 patients who had infected CVGs (29%). All 4 patients who had infected CVGs replaced with aortic root homografts survived. Complications included vocal cord paralysis (n = 4, 12%), bleeding requiring reoperation (n = 3, 9%) and stroke (n = 2, 6%). Actuarial 3-year survival was 74.4% +/- 7.9%. CONCLUSIONS: Reoperations in patients with CVGs remain challenging procedures with high associated morbidity and mortality, especially in the setting of graft infection. The results of homograft aortic root re-replacement for infected CVGs are encouraging.
BACKGROUND: The purpose of this study was to examine our experience with proximal aortic reoperations in patients with composite valve grafts (CVGs) and assess postoperative survival and morbidity. METHODS: Since 1991, 33 patients with CVGs underwent reoperation for one or more of the following indications: aneurysms distal to the CVG (n = 20, 61%), false aneurysms (n = 13, 39%) and graft infection (n = 7, 21%). Operations included false aneurysm repair (n = 13, 39%), graft replacement of distal ascending aortic or transverse aortic arch aneurysm (n = 20, 61%) and aortic root re-replacement with a new CVG (n = 6, 18%) or homograft (n = 4, 12%). RESULTS: Operative mortality was 15% (n = 5), including 2 of the 7 patients who had infected CVGs (29%). All 4 patients who had infected CVGs replaced with aortic root homografts survived. Complications included vocal cord paralysis (n = 4, 12%), bleeding requiring reoperation (n = 3, 9%) and stroke (n = 2, 6%). Actuarial 3-year survival was 74.4% +/- 7.9%. CONCLUSIONS: Reoperations in patients with CVGs remain challenging procedures with high associated morbidity and mortality, especially in the setting of graft infection. The results of homograft aortic root re-replacement for infected CVGs are encouraging.
Authors: Mohamad Bashir; Matthew Fok; Matthew Shaw; Mark Field; Manoj Kuduvalli; Michael Desmond; Deborah Harrington; Abbas Rashid; Aung Oo Journal: Aorta (Stamford) Date: 2014-06-01
Authors: Alexander Iribarne; Jeffrey Keenan; Ehsan Benrashid; Hanghang Wang; James M Meza; Asvin Ganapathi; Jeffrey G Gaca; Han W Kim; Lynne M Hurwitz; G Chad Hughes Journal: Ann Thorac Surg Date: 2016-09-24 Impact factor: 4.330
Authors: Aron Frederik Popov; Mersa Mohammed Baryalei; Jan Dieter Schmitto; Jose Hinz; Christoph Hermann Wiese; Björn Raab; Philipp Kolat; Friedrich Albert Schoendube; Ralf Seipelt Journal: J Cardiothorac Surg Date: 2009-01-02 Impact factor: 1.637