Literature DB >> 12537204

A long-term experience with the Cabrol root replacement technique for the management of ascending aortic aneurysms and dissections.

Sandro Gelsomino1, Romeo Frassani, Paolo Da Col, Giorgio Morocutti, Gianluca Masullo, Leonardo Spedicato, Ugolino Livi.   

Abstract

BACKGROUND: Little information exists regarding the long-term results of the Cabrol technique. This study aimed at exploring, over a 16-year period, the results of aortic root replacements employing this procedure.
METHODS: Between 1986 and 2002 forty-five patients (mean age 58.7 +/- 13.8 years old, 84.4% male) underwent a Cabrol procedure. Aortic dissection was the most frequent cause of aortic disease in this series (n = 17), followed by annuloaortic ectasia (n = 10), atherosclerotic aneurysm (n = 5) and poststenotic dilatation (n = 5). Six patients (13.4%) had undergone a previous aortic operation, 8 (17.7%) had a Marfan syndrome and five (11.1%) underwent concomitant arch replacement. Mean clinical follow-up was 87.3 +/- 24.3 months. Twenty-eight patients (93.3% of survivors) had a transesophageal echocardiography (TEE) performed at a mean of 64 +/- 32 months postoperatively.
RESULTS: Early mortality was 20%. It was 9.1% for patients with an ascending aortic aneurysm and 41.2% for dissections (p = 0.026). Independent multivariate predictors of early mortality were: aortic dissection (p = 0.009), emergency operation (p < 0.001), operative year (p = 0.02), cross-clamp time (p = 0.001), and CPB duration (p < 0.001). Actuarial survival was 0.77 +/- 0.06, 0.72 +/- 0.06, 0.59 +/- 0.04 and 0.59 +/- 0.04 at 1, 5, 10, and 16 years, respectively. Multivariate analysis revealed age (p = 0.007), cross-clamp time (p = 0.0006) and CPB duration (p = 0.009) as strong predictors of poor late survival. A periprosthetic jet with significant valve regurgitation was detected by TEE in 3 patients. In one of them, an infected periprosthetic space-right ventricular fistula was demonstrated requiring reoperation. Altogether, freedom from reoperation and endocarditis at 16 years was 0.97 +/- 0.02 and 0.94 +/- 0.03, respectively.
CONCLUSIONS: The Cabrol technique demonstrated a nonnegligible incidence of early and long-term complications. It should be rarely used and only when a "button" technique is not feasible.

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Year:  2003        PMID: 12537204     DOI: 10.1016/s0003-4975(02)04284-4

Source DB:  PubMed          Journal:  Ann Thorac Surg        ISSN: 0003-4975            Impact factor:   4.330


  13 in total

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Review 2.  Evolution of surgical therapy for Stanford acute type A aortic dissection.

Authors:  Peter Chiu; D Craig Miller
Journal:  Ann Cardiothorac Surg       Date:  2016-07

Review 3.  Pre- and Postoperative Imaging of the Aortic Root.

Authors:  Kate Hanneman; Frandics P Chan; R Scott Mitchell; D Craig Miller; Dominik Fleischmann
Journal:  Radiographics       Date:  2015-11-27       Impact factor: 5.333

4.  An acutely occluded Cabrol graft presenting as an acute coronary syndrome.

Authors:  Joshua Schulman-Marcus; Nicholas Cochran-Caggiano; Mohammad El-Hajjar; Chanderdeep Singh
Journal:  BMJ Case Rep       Date:  2019-07-23

Review 5.  Isolated right ventricular infarction after modified Cabrol operation.

Authors:  Reji M Pappy; Elias B Hanna; Marvin D Peyton; Jorge F Saucedo
Journal:  Tex Heart Inst J       Date:  2012

6.  Aortic Root Reconstruction with a New Dacron Graft Featuring Prefabricated Coronary Side Branches: Lessons Learned from the Cabrol Procedure.

Authors:  Domenico Calcaterra; Mohammad-Ali Jazayeri; Joseph W Turek; Kalpaj R Parekh; Mohammad Bashir; Karam Karam; Robert S Farivar
Journal:  Aorta (Stamford)       Date:  2017-02-01

7.  A successful primary percutaneous coronary intervention twelve days after a cabrol composite graft operation in marfan syndrome.

Authors:  Won Il Jang; Jin-Ok Jeong; Kye-Taek Ahn; Hyung Seo Park; Jae-Hyeong Park; Song Soo Kim; Jae-Hwan Lee; Si-Wan Choi; In-Whan Seong
Journal:  Korean Circ J       Date:  2010-05-27       Impact factor: 3.243

8.  Eighteen years of clinical experience with a modification of the Bentall button technique for total root replacement.

Authors:  Dimos Karangelis; Dimitrios Tzertzemelis; Alexandros A Demis; Stella Economidou; Matthew Panagiotou
Journal:  J Thorac Dis       Date:  2018-12       Impact factor: 2.895

9.  Rescue surgery 19 years after composite root and hemiarch replacement.

Authors:  Konstantin von Aspern; Joerg Seeburger; Christian D Etz; Matthias Sauer; Lukas Lehmkuhl; Martin Misfeld; Friedrich W Mohr
Journal:  Case Rep Surg       Date:  2013-04-10

10.  Hemi-Cabrol Aortic Root Replacement in Complex Aortic Reconstructions.

Authors:  Ioannis Dimarakis; Isaac Kadir
Journal:  Aorta (Stamford)       Date:  2018-07-27
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