BACKGROUND: Acute type A aortic dissection frequently occurs in patients with normally sized aortic roots. The aim of this investigation was to describe the durability of aortic valve resuspension and root repair with a novel technique of reconstruction in type A dissection. METHODS: From 1993 to 2013, among 629 patients operated on for acute type A dissection 489 (62% male, median age 62 years (53; 73) underwent aortic valve resuspension and reinforcement of the sinus of Valsalva with a Teflon felt neomedia. The median follow-up time was 4.1 years (1.3; 6.8) (2075 patient-years). RESULTS: In-hospital mortality was 11% (56/489). Survival was 69%±2%, 50%±3%, and 36%±5% at 5, 10, and 15 years, respectively. Freedom from moderate or severe aortic regurgitation was not influenced by the aortic regurgitation grade at the initial operation (p=0.131). Freedom from proximal aortic reoperation was 96%±1%, 92%±2%, and 89%±4% at 5, 10, and 15 years, respectively. Seventeen patients (3%) required proximal reoperation: 10 for aortic regurgitation, including 3 with concomitant pseudoaneurysm and 2 with root aneurysm; 6 for pseudoaneurysm; and 1 for graft infection. CONCLUSIONS: Aortic root neomedia reconstruction and valve resuspension can be successfully performed in the majority of patients with type A dissection. The in-hospital mortality is low, and the results are durable.
BACKGROUND: Acute type A aortic dissection frequently occurs in patients with normally sized aortic roots. The aim of this investigation was to describe the durability of aortic valve resuspension and root repair with a novel technique of reconstruction in type A dissection. METHODS: From 1993 to 2013, among 629 patients operated on for acute type A dissection 489 (62% male, median age 62 years (53; 73) underwent aortic valve resuspension and reinforcement of the sinus of Valsalva with a Teflon felt neomedia. The median follow-up time was 4.1 years (1.3; 6.8) (2075 patient-years). RESULTS: In-hospital mortality was 11% (56/489). Survival was 69%±2%, 50%±3%, and 36%±5% at 5, 10, and 15 years, respectively. Freedom from moderate or severe aortic regurgitation was not influenced by the aortic regurgitation grade at the initial operation (p=0.131). Freedom from proximal aortic reoperation was 96%±1%, 92%±2%, and 89%±4% at 5, 10, and 15 years, respectively. Seventeen patients (3%) required proximal reoperation: 10 for aortic regurgitation, including 3 with concomitant pseudoaneurysm and 2 with root aneurysm; 6 for pseudoaneurysm; and 1 for graft infection. CONCLUSIONS: Aortic root neomedia reconstruction and valve resuspension can be successfully performed in the majority of patients with type A dissection. The in-hospital mortality is low, and the results are durable.
Authors: Maximilian Kreibich; Bartosz Rylski; Stoyan Kondov; Julia Morlock; Johannes Scheumann; Fabian A Kari; Holger Schröfel; Matthias Siepe; Friedhelm Beyersdorf; Martin Czerny Journal: J Vis Surg Date: 2018-04-04
Authors: Bo Yang; Elizabeth L Norton; Reilly Hobbs; Linda Farhat; Xiaoting Wu; Whitney E Hornsby; Karen M Kim; Himanshu J Patel; G Michael Deeb Journal: J Thorac Cardiovasc Surg Date: 2018-12-21 Impact factor: 5.209
Authors: Peter Chiu; Jeffrey Trojan; Sarah Tsou; Andrew B Goldstone; Y Joseph Woo; Michael P Fischbein Journal: J Thorac Cardiovasc Surg Date: 2017-09-19 Impact factor: 5.209
Authors: Wei-Guo Ma; Bulat A Ziganshin; Chang-Fa Guo; Mohammad A Zafar; Richard S Sieller; Maryann Tranquilli; John A Elefteriades Journal: J Thorac Dis Date: 2017-08 Impact factor: 2.895
Authors: Elizabeth L Norton; David M Williams; Karen M Kim; Xiaoting Wu; Minhaj S Khaja; Himanshu J Patel; G Michael Deeb; Bo Yang Journal: Ann Cardiothorac Surg Date: 2019-09