Araştırma Makalesi
BibTex RIS Kaynak Göster

Mid-Term Results of Aortic Valve Sparing Root Surgery Operations

Yıl 2023, Cilt: 26 Sayı: 2, 55 - 61, 12.07.2023

Öz

Introduction: In this study, we retrospectively analyzed the mid-term outcomes of patients who underwent aortic valve-sparing root replacement (VSARR).

Patients and Methods: Ninety-six patients operated on due to annuloaortic ectasia in our clinic between 2012 and 2016 were examined. Twenty-four patients who underwent VSARR were included in the study. They were evaluated using echocardiography and computed tomography in terms of mortality and reoperation according to their preoperative demographic characteristics, aortic regurgitation (AR), and annular dilatation levels.

Results: The early mortality rate was 12.5% (n= 3) and was associated with emergency operation and total arch replacement. The mean follow-up was 33.00 ± 9.53 months. The early mortality rate was 12.5% (n= 3) and was associated with emergency surgery and total arch replacement (p= 0.035, p< 0.05). The mean followup was 33.00 ± 9.53 months. None of the patients required reoperation. While postoperative AR was seen in one patient with Takayasu’s arteritis (n= 1, 4.16%), it was not observed in the patients with Marfan syndrome or bicuspid aortic valve disease. Postoperative AR and preoperative AR were related (p= 0.012, p< 0.05), but preoperative annulus diameter was not (p= 0.296, p> 0.05). There was no difference in valve durability between the use of Dacron and Valsalva grafts (p= 0.724, p> 0.05).

Conclusion: For patients with aortic root aneurysms, elective VSARR is a good surgical option. However, the presence of comorbidities is related to high mortality because it necessitates urgent and complicated surgery for patients with aortic dissection.

Kaynakça

  • 1. Bentall H, De Bono A. A technique for complete replacement of ascending aorta. Thorax 1968;23:338-9. [Crossref]
  • 2. David TE, Feindel CM. An aortic valve-sparing operation for patients with aortic incompetence and aneurysm of the ascending aorta. J Thorac Cardiovasc Surg 1992;103:617-22. [Crossref]
  • 3. Yacoub MH, Gehle P, Chandrasekaran V, Birks EJ, Child A, Radley-Smith R. Late results of a valve-preserving operation in patients with aneurysms of the ascending aorta and root. J Thorac Cardiovasc Surg 1998;115:1080- 90. [Crossref]
  • 4. De Meester C, Pasquet A, Gerber BL, Vancraeynest D, Noirhomme P, El Khoury G, et al. Valve repair improves the outcome of surgery for chronic severe aortic regurgitation: A propensity score analysis. J Thorac Cardiovasc Surg 2014;148:1913-20. [Crossref]
  • 5. Ouzounian M, Rao V, Manlhiot C, Abraham N, David C, Feindel CM, et al. Valve-sparing root replacement compared with composite valve graft procedures in patients with aortic root dilation. J Am Coll Cardiol 2016;68:1838-47. [Crossref]
  • 6. Sarsam MA, Yacoub M. Remodeling of the aortic valve anulus. J Thorac Cardiovasc Surg 1993;105:435-8. [Crossref]
  • 7. Miller DC. Valve-sparing aortic root replacement in patients with Marfan syndrome. J Thorac Cardiovasc Surg 2003;125:773-8. [Crossref]
  • 8. Urbanski PP, Zhan X, Hijazi H, Zacher M, Diegeler A. Valve-sparing aortic root repair without down-sizing of the annulus. J Thorac Cardiovasc Surg 2012;143:294-302. [Crossref]
  • 9. Liu L, Wang W, Wang X, Tian C, Meng YH, Chang Q. Reimplantation versus remodeling: A meta-analysis. J Card Surg 2011;26:82-7. [Crossref]
  • 10. Arabkhani B, Mookhoek A, Di Centa I, Lansac E, Bekkers JA, Van Wijngaarden RDL, et al. Reported outcome after valve-sparing aortic root replacement for aortic root aneurysm: A systematic review and meta-analysis. Ann Thorac Surg 2015;100:1126-31. [Crossref]
  • 11. Hanke T, Charitos EI, Steirle U, Robinson D, CStat P, Gorski A, et al. Factors associated with the development of aortic valve regurgitation over time after two different techniques of valve-sparing aortic root surgery. J Thorac Cardiovasc Surg 2009;137:314-9. [Crossref]
  • 12. David TE, Armstrong S, Maganti M, Colman J, Bradley TJ. Long-term results of aortic valve-sparing operations in patients with Marfan syndrome. J Thorac Cardiovasc Surg 2009;138:859-64. [Crossref]
  • 13. De Paulis R, Chirichilli I, Scaffa R, Weltert L, Maselli D, Salica A, et al. Long-term results of the valve reimplantation technique using a graft with sinuses. J Thorac Cardiovasc Surg 2016;151:112-9 [Crossref]
  • 14. Leyh RG, Schmidtke C, Sievers HH, Yacoub MH. Opening and closing characteristics of the aortic valve after different types of valve-preserving surgery. Circulation 1999;100:2153-60. [Crossref]
  • 15. Fries R, Graeter T, Aicher D, Reul H, Schmitz C, Böhm M, et al. In vitro comparison of aortic valve movement after valve-preserving aortic replacement. J Thorac Cardiovasc Surg 2006;132:32-7. [Crossref]
  • 16. Schmidtke C, Sievers HH, Frydrychowicz A, Petersen M, Scharfschwerdt M, Karluss A, et al. First clinical results with the new sinus prosthesis used for valve-sparing aortic root replacement. Eur J Cardiothorac Surg 2013;43:585-90. [Crossref]
  • 17. Beckmann E, Leone A, Martens A, Mariani C, Krueger H, Shrestha ML, et al. A comparison of two stategies for aortic valve-sparing root replacement. Ann Thorac Surg 2020;109:505-11. [Crossref]
  • 18. Settepani F, Szeto WY, Pacini D, De Paulis R, Chiariello L, Di Bartolomeo R, et al. Reimplantation valve-sparing aortic root replacement in Marfan syndrome using the Valsalva conduit: An intercontinental multicenter study. Ann Thorac Surg 2007;83:769-73. [Crossref]
  • 19. Pacini D, Settepani F, Paulis RD, Loforte A, Nardella S, Ornaghi D, et al. Early results of valve-sparing reimplantation procedure using the Valsalva conduit: A multicenter study. Ann Thorac Surg 2006;82:865-72. [Crossref]
  • 20. David TE. Reimplantation valve-sparing aortic root replacement is the most durable approach to faciliate aortic valve repair. JTCVS Techniques 2021;7:72-8. [Crossref]
  • 21. Aicher D, Langer F, Lausber H, Bierbach B, Schäfers H. Aortic root remodeling: Ten-year experience with 274 patients. J Thoracic Cardiovasc Surg 2007;134:909-15. [Crossref]
  • 22. Franke UF, Isecke A, Nagib R, Breuer M, Wippermann J, Tigges-Limmer K, et al. Quality of life after aortic root surgery: Reimplantation technique versus composite replacement. Ann Thorac Surg 2010;90:1869-75. [Crossref]
  • 23. Dailiy PO, Truwblood HW, Stinson EB, Wuerflein RD, Shumway NE. management of acute aortic dissections. Ann Thorac Surg 1970;10:568- 73. [Crossref]
  • 24. Attar S, Fardin R, Ayella R, McLaughlin JS. Medical vs surgical treatment of acute dissecting aneuysms. Arch Surg 1971;103:568-73. [Crossref]
  • 25. Geirson A, Bavaria JE, Swarr D, Keane MG, Woo YJ, Szeto WY, et al. Fate of the residual distal and proximal aorta after acute type a dissection repair using a contemporary surgical reconstruction algorithm. Ann Thorac Surg 2007;84:1955-64. [Crossref]
  • 26. Yang B, Malik A, Waidley V, Kleeman KC, Wu X, Norton EL, et al. Short-term outcomes of a simple and effective approach to aortic root and arch repair in acute type A aortic dissection. J Thorac Cardiovasc Surg 2018;155:1360-70. [Crossref]
  • 27. Aubin H, Akhyari P, Rellecke P, Pawlitza C, Petrov G, Lichtenberg A, Kamiya H. Valve-sparing aortic root replacement as first-choice strategy in acute type a aortic dissection. Front Surg 2019;6:46. [Crossref]
  • 28. Mosbahi S, Stak D, Gravestock I, Burgstaller JM, Steurer J, Eckstein F, et al. A systemic review and meta-analysis: Benthall versus David procedure in acute type A aortic dissection. Eur J Cardiothorac Surg 2019;55:201:9. [Crossref]
  • 29. David TE, Maganti M, Armstrong S. Aortic root aneurysm: principles of repair and long-term follow-up. J Thoracic Cardiovasc Surg 2010;140:14- 9 [Crossref]
  • 30. Beckmann E, Martens A, Alhadi FA, Ius F, Koigeldiyev N, Fleissner F, et al. Is Bentall procedure still gold standart for acute aortic dissection with aortic root involvement? Thorac Cardiovasc 2016;64:116-23. [Crossref]
  • 31. Ahmed EM, Chen EP. Management of the aortic root in type A aortic dissection: A valve sparing approach. J Card Surg 2020;1-4. [Crossref]
  • 32. Beckmann E, Martens A, Krüger H, Korte W, Kaufeld T, Stettinger A, Haverich A, Shrestha ML. Aortic valve-sparing root replacement with Tirone E. David’s reimplantation technique: Single-centre 25-year experience. Eur J Cardio Thoracic Surg 2021;1-7. [Crossref]
  • 33. Zhou Z, Liang M, Huang S, Wu Z. Reimplantation versus remodeling in valve-sparing surgery for aortic root aneurysms: A meta-analysis. J Thorac Dis 2020;12:4742-53. [Crossref].
Yıl 2023, Cilt: 26 Sayı: 2, 55 - 61, 12.07.2023

Öz

Kaynakça

  • 1. Bentall H, De Bono A. A technique for complete replacement of ascending aorta. Thorax 1968;23:338-9. [Crossref]
  • 2. David TE, Feindel CM. An aortic valve-sparing operation for patients with aortic incompetence and aneurysm of the ascending aorta. J Thorac Cardiovasc Surg 1992;103:617-22. [Crossref]
  • 3. Yacoub MH, Gehle P, Chandrasekaran V, Birks EJ, Child A, Radley-Smith R. Late results of a valve-preserving operation in patients with aneurysms of the ascending aorta and root. J Thorac Cardiovasc Surg 1998;115:1080- 90. [Crossref]
  • 4. De Meester C, Pasquet A, Gerber BL, Vancraeynest D, Noirhomme P, El Khoury G, et al. Valve repair improves the outcome of surgery for chronic severe aortic regurgitation: A propensity score analysis. J Thorac Cardiovasc Surg 2014;148:1913-20. [Crossref]
  • 5. Ouzounian M, Rao V, Manlhiot C, Abraham N, David C, Feindel CM, et al. Valve-sparing root replacement compared with composite valve graft procedures in patients with aortic root dilation. J Am Coll Cardiol 2016;68:1838-47. [Crossref]
  • 6. Sarsam MA, Yacoub M. Remodeling of the aortic valve anulus. J Thorac Cardiovasc Surg 1993;105:435-8. [Crossref]
  • 7. Miller DC. Valve-sparing aortic root replacement in patients with Marfan syndrome. J Thorac Cardiovasc Surg 2003;125:773-8. [Crossref]
  • 8. Urbanski PP, Zhan X, Hijazi H, Zacher M, Diegeler A. Valve-sparing aortic root repair without down-sizing of the annulus. J Thorac Cardiovasc Surg 2012;143:294-302. [Crossref]
  • 9. Liu L, Wang W, Wang X, Tian C, Meng YH, Chang Q. Reimplantation versus remodeling: A meta-analysis. J Card Surg 2011;26:82-7. [Crossref]
  • 10. Arabkhani B, Mookhoek A, Di Centa I, Lansac E, Bekkers JA, Van Wijngaarden RDL, et al. Reported outcome after valve-sparing aortic root replacement for aortic root aneurysm: A systematic review and meta-analysis. Ann Thorac Surg 2015;100:1126-31. [Crossref]
  • 11. Hanke T, Charitos EI, Steirle U, Robinson D, CStat P, Gorski A, et al. Factors associated with the development of aortic valve regurgitation over time after two different techniques of valve-sparing aortic root surgery. J Thorac Cardiovasc Surg 2009;137:314-9. [Crossref]
  • 12. David TE, Armstrong S, Maganti M, Colman J, Bradley TJ. Long-term results of aortic valve-sparing operations in patients with Marfan syndrome. J Thorac Cardiovasc Surg 2009;138:859-64. [Crossref]
  • 13. De Paulis R, Chirichilli I, Scaffa R, Weltert L, Maselli D, Salica A, et al. Long-term results of the valve reimplantation technique using a graft with sinuses. J Thorac Cardiovasc Surg 2016;151:112-9 [Crossref]
  • 14. Leyh RG, Schmidtke C, Sievers HH, Yacoub MH. Opening and closing characteristics of the aortic valve after different types of valve-preserving surgery. Circulation 1999;100:2153-60. [Crossref]
  • 15. Fries R, Graeter T, Aicher D, Reul H, Schmitz C, Böhm M, et al. In vitro comparison of aortic valve movement after valve-preserving aortic replacement. J Thorac Cardiovasc Surg 2006;132:32-7. [Crossref]
  • 16. Schmidtke C, Sievers HH, Frydrychowicz A, Petersen M, Scharfschwerdt M, Karluss A, et al. First clinical results with the new sinus prosthesis used for valve-sparing aortic root replacement. Eur J Cardiothorac Surg 2013;43:585-90. [Crossref]
  • 17. Beckmann E, Leone A, Martens A, Mariani C, Krueger H, Shrestha ML, et al. A comparison of two stategies for aortic valve-sparing root replacement. Ann Thorac Surg 2020;109:505-11. [Crossref]
  • 18. Settepani F, Szeto WY, Pacini D, De Paulis R, Chiariello L, Di Bartolomeo R, et al. Reimplantation valve-sparing aortic root replacement in Marfan syndrome using the Valsalva conduit: An intercontinental multicenter study. Ann Thorac Surg 2007;83:769-73. [Crossref]
  • 19. Pacini D, Settepani F, Paulis RD, Loforte A, Nardella S, Ornaghi D, et al. Early results of valve-sparing reimplantation procedure using the Valsalva conduit: A multicenter study. Ann Thorac Surg 2006;82:865-72. [Crossref]
  • 20. David TE. Reimplantation valve-sparing aortic root replacement is the most durable approach to faciliate aortic valve repair. JTCVS Techniques 2021;7:72-8. [Crossref]
  • 21. Aicher D, Langer F, Lausber H, Bierbach B, Schäfers H. Aortic root remodeling: Ten-year experience with 274 patients. J Thoracic Cardiovasc Surg 2007;134:909-15. [Crossref]
  • 22. Franke UF, Isecke A, Nagib R, Breuer M, Wippermann J, Tigges-Limmer K, et al. Quality of life after aortic root surgery: Reimplantation technique versus composite replacement. Ann Thorac Surg 2010;90:1869-75. [Crossref]
  • 23. Dailiy PO, Truwblood HW, Stinson EB, Wuerflein RD, Shumway NE. management of acute aortic dissections. Ann Thorac Surg 1970;10:568- 73. [Crossref]
  • 24. Attar S, Fardin R, Ayella R, McLaughlin JS. Medical vs surgical treatment of acute dissecting aneuysms. Arch Surg 1971;103:568-73. [Crossref]
  • 25. Geirson A, Bavaria JE, Swarr D, Keane MG, Woo YJ, Szeto WY, et al. Fate of the residual distal and proximal aorta after acute type a dissection repair using a contemporary surgical reconstruction algorithm. Ann Thorac Surg 2007;84:1955-64. [Crossref]
  • 26. Yang B, Malik A, Waidley V, Kleeman KC, Wu X, Norton EL, et al. Short-term outcomes of a simple and effective approach to aortic root and arch repair in acute type A aortic dissection. J Thorac Cardiovasc Surg 2018;155:1360-70. [Crossref]
  • 27. Aubin H, Akhyari P, Rellecke P, Pawlitza C, Petrov G, Lichtenberg A, Kamiya H. Valve-sparing aortic root replacement as first-choice strategy in acute type a aortic dissection. Front Surg 2019;6:46. [Crossref]
  • 28. Mosbahi S, Stak D, Gravestock I, Burgstaller JM, Steurer J, Eckstein F, et al. A systemic review and meta-analysis: Benthall versus David procedure in acute type A aortic dissection. Eur J Cardiothorac Surg 2019;55:201:9. [Crossref]
  • 29. David TE, Maganti M, Armstrong S. Aortic root aneurysm: principles of repair and long-term follow-up. J Thoracic Cardiovasc Surg 2010;140:14- 9 [Crossref]
  • 30. Beckmann E, Martens A, Alhadi FA, Ius F, Koigeldiyev N, Fleissner F, et al. Is Bentall procedure still gold standart for acute aortic dissection with aortic root involvement? Thorac Cardiovasc 2016;64:116-23. [Crossref]
  • 31. Ahmed EM, Chen EP. Management of the aortic root in type A aortic dissection: A valve sparing approach. J Card Surg 2020;1-4. [Crossref]
  • 32. Beckmann E, Martens A, Krüger H, Korte W, Kaufeld T, Stettinger A, Haverich A, Shrestha ML. Aortic valve-sparing root replacement with Tirone E. David’s reimplantation technique: Single-centre 25-year experience. Eur J Cardio Thoracic Surg 2021;1-7. [Crossref]
  • 33. Zhou Z, Liang M, Huang S, Wu Z. Reimplantation versus remodeling in valve-sparing surgery for aortic root aneurysms: A meta-analysis. J Thorac Dis 2020;12:4742-53. [Crossref].
Toplam 33 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Kardiyoloji
Bölüm Orijinal Araştırmalar
Yazarlar

Berra Zümrüt Tan Recep Bu kişi benim 0000-0002-9833-1363

Deniz Göksedef Bu kişi benim 0000-0002-9833-1363

Yayımlanma Tarihi 12 Temmuz 2023
Yayımlandığı Sayı Yıl 2023 Cilt: 26 Sayı: 2

Kaynak Göster

Vancouver Tan Recep BZ, Göksedef D. Mid-Term Results of Aortic Valve Sparing Root Surgery Operations. Koşuyolu Heart Journal. 2023;26(2):55-61.