OBJECTIVES: To evaluate short- and medium-term outcomes following Liu's aortic root repair and valve preservation in patients with acute type A aortic dissection complicated by moderate-to-severe aortic regurgitation (AR). METHODS: From October 2011 to July 2018, a total of 324 consecutive patients underwent emergency surgery for acute type A aortic dissection. There were 122 patients (38%) with moderate-to-severe AR, of whom 82 (67%) underwent Liu's aortic root repair and valve preservation. Aortic computed tomography angiography and echocardiography were performed at discharge, 6 and 12 months postoperatively, and annually thereafter. We focused on assessing the survival and aortic root and valve durability in the 82 patients. RESULTS: The 30-day, 1-year, 3-year and 6-year survival estimates were 94%, 90%, 85% and 81%, respectively. At a median follow-up of 36.5 (interquartile range 24.9-50.9) months, all patients were free from reoperation. No residual false lumens in the aortic root, recurrent aortic root dissections or aortic root pseudoaneurysms were observed during the follow-up period. Only 1 patient (1%) presented with moderate AR at 6 months, which remained asymptomatic with no significant changes over a 3-year period. The remaining patients showed satisfactory valve function with an AR grade of mild (27%) or trace or none (72%). In the competing risk analysis, the incidence of recurrence of AR was 2% at 8 years. CONCLUSIONS: Liu's aortic root repair and valve preservation is a safe and effective operative strategy that achieves favourable short- and medium-term outcomes for acute type A aortic dissection with moderate-to-severe AR.
OBJECTIVES: To evaluate short- and medium-term outcomes following Liu's aortic root repair and valve preservation in patients with acute type A aortic dissection complicated by moderate-to-severe aortic regurgitation (AR). METHODS: From October 2011 to July 2018, a total of 324 consecutive patients underwent emergency surgery for acute type A aortic dissection. There were 122 patients (38%) with moderate-to-severe AR, of whom 82 (67%) underwent Liu's aortic root repair and valve preservation. Aortic computed tomography angiography and echocardiography were performed at discharge, 6 and 12 months postoperatively, and annually thereafter. We focused on assessing the survival and aortic root and valve durability in the 82 patients. RESULTS: The 30-day, 1-year, 3-year and 6-year survival estimates were 94%, 90%, 85% and 81%, respectively. At a median follow-up of 36.5 (interquartile range 24.9-50.9) months, all patients were free from reoperation. No residual false lumens in the aortic root, recurrent aortic root dissections or aortic root pseudoaneurysms were observed during the follow-up period. Only 1 patient (1%) presented with moderate AR at 6 months, which remained asymptomatic with no significant changes over a 3-year period. The remaining patients showed satisfactory valve function with an AR grade of mild (27%) or trace or none (72%). In the competing risk analysis, the incidence of recurrence of AR was 2% at 8 years. CONCLUSIONS: Liu's aortic root repair and valve preservation is a safe and effective operative strategy that achieves favourable short- and medium-term outcomes for acute type A aortic dissection with moderate-to-severe AR.
Authors: David T Lai; D Craig Miller; R Scott Mitchell; Philip E Oyer; Kathleen A Moore; Robert C Robbins; Norman E Shumway; Bruce A Reitz Journal: J Thorac Cardiovasc Surg Date: 2003-12 Impact factor: 5.209
Authors: Rick A Nishimura; Catherine M Otto; Robert O Bonow; Blase A Carabello; John P Erwin; Robert A Guyton; Patrick T O'Gara; Carlos E Ruiz; Nikolaos J Skubas; Paul Sorajja; Thoralf M Sundt; James D Thomas Journal: Circulation Date: 2014-03-03 Impact factor: 29.690
Authors: R Pessotto; F Santini; P Pugliese; G Montalbano; G B Luciani; G Faggian; P Bertolini; A Mazzucco Journal: Ann Thorac Surg Date: 1999-06 Impact factor: 4.330
Authors: Zhengjun Wang; Kevin L Greason; Alberto Pochettino; Hartzell V Schaff; Rakesh M Suri; John M Stulak; Joseph A Dearani Journal: J Thorac Cardiovasc Surg Date: 2014-01-15 Impact factor: 5.209
Authors: L K von Segesser; E Lorenzetti; M Lachat; U Niederhäuser; M Schönbeck; P R Vogt; M I Turina Journal: J Thorac Cardiovasc Surg Date: 1996-02 Impact factor: 5.209