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Surgery of the aortic root: should we go for the valve-sparing root reconstruction or the composite graft-valve replacement is still the first choice of treatment for these patients?
OBJECTIVE: To compare the results of the root reconstruction with the aortic valve-sparing operation versus composite graftvalve replacement. METHODS: From January 2002 to October 2013, 324 patients underwent aortic root reconstruction. They were 263 composite graft-valve replacement and 61 aortic v...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Sociedade Brasileira de Cirurgia Cardiovascular
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4541781/ https://www.ncbi.nlm.nih.gov/pubmed/26313725 http://dx.doi.org/10.5935/1678-9741.20150028 |
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author | Lamana, Fernando de Azevedo Dias, Ricardo Ribeiro Duncan, Jose Augusto de Faria, Leandro Batisti Malbouisson, Luiz Marcelo Sa Borges, Luciano de Figueiredo Mady, Charles Jatene, Fábio Biscegli |
author_facet | Lamana, Fernando de Azevedo Dias, Ricardo Ribeiro Duncan, Jose Augusto de Faria, Leandro Batisti Malbouisson, Luiz Marcelo Sa Borges, Luciano de Figueiredo Mady, Charles Jatene, Fábio Biscegli |
author_sort | Lamana, Fernando de Azevedo |
collection | PubMed |
description | OBJECTIVE: To compare the results of the root reconstruction with the aortic valve-sparing operation versus composite graftvalve replacement. METHODS: From January 2002 to October 2013, 324 patients underwent aortic root reconstruction. They were 263 composite graft-valve replacement and 61 aortic valve-sparing operation (43 reimplantation and 18 remodeling). Twenty-six percent of the patients were NYHA functional class III and IV; 9.6% had Marfan syndrome, and 12% had bicuspid aortic valve. There was a predominance of aneurysms over dissections (81% vs. 19%), with 7% being acute dissections. The complete follow-up of 100% of the patients was performed with median follow-up time of 902 days for patients undergoing composite graft-valve replacement and 1492 for those undergoing aortic valve-sparing operation. RESULTS: In-hospital mortality was 6.7% and 4.9%, respectively for composite graft-valve replacement and aortic valve-sparing operation (ns). During the late follow-up period, there was 0% moderate and 15.4% severe aortic regurgitation, and NYHA functional class I and II were 89.4% and 94%, respectively for composite graft-valve replacement and aortic valve-sparing operation (ns). Root reconstruction with aortic valve-sparing operation showed lower late mortality (P=0.001) and lower bleeding complications (P=0.006). There was no difference for thromboembolism, endocarditis, and need of reoperation. CONCLUSION: The aortic root reconstruction with preservation of the valve should be the operation being performed for presenting lower late mortality and survival free of bleeding events. |
format | Online Article Text |
id | pubmed-4541781 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Sociedade Brasileira de Cirurgia Cardiovascular |
record_format | MEDLINE/PubMed |
spelling | pubmed-45417812015-08-20 Surgery of the aortic root: should we go for the valve-sparing root reconstruction or the composite graft-valve replacement is still the first choice of treatment for these patients? Lamana, Fernando de Azevedo Dias, Ricardo Ribeiro Duncan, Jose Augusto de Faria, Leandro Batisti Malbouisson, Luiz Marcelo Sa Borges, Luciano de Figueiredo Mady, Charles Jatene, Fábio Biscegli Rev Bras Cir Cardiovasc Original Article OBJECTIVE: To compare the results of the root reconstruction with the aortic valve-sparing operation versus composite graftvalve replacement. METHODS: From January 2002 to October 2013, 324 patients underwent aortic root reconstruction. They were 263 composite graft-valve replacement and 61 aortic valve-sparing operation (43 reimplantation and 18 remodeling). Twenty-six percent of the patients were NYHA functional class III and IV; 9.6% had Marfan syndrome, and 12% had bicuspid aortic valve. There was a predominance of aneurysms over dissections (81% vs. 19%), with 7% being acute dissections. The complete follow-up of 100% of the patients was performed with median follow-up time of 902 days for patients undergoing composite graft-valve replacement and 1492 for those undergoing aortic valve-sparing operation. RESULTS: In-hospital mortality was 6.7% and 4.9%, respectively for composite graft-valve replacement and aortic valve-sparing operation (ns). During the late follow-up period, there was 0% moderate and 15.4% severe aortic regurgitation, and NYHA functional class I and II were 89.4% and 94%, respectively for composite graft-valve replacement and aortic valve-sparing operation (ns). Root reconstruction with aortic valve-sparing operation showed lower late mortality (P=0.001) and lower bleeding complications (P=0.006). There was no difference for thromboembolism, endocarditis, and need of reoperation. CONCLUSION: The aortic root reconstruction with preservation of the valve should be the operation being performed for presenting lower late mortality and survival free of bleeding events. Sociedade Brasileira de Cirurgia Cardiovascular 2015 /pmc/articles/PMC4541781/ /pubmed/26313725 http://dx.doi.org/10.5935/1678-9741.20150028 Text en http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Lamana, Fernando de Azevedo Dias, Ricardo Ribeiro Duncan, Jose Augusto de Faria, Leandro Batisti Malbouisson, Luiz Marcelo Sa Borges, Luciano de Figueiredo Mady, Charles Jatene, Fábio Biscegli Surgery of the aortic root: should we go for the valve-sparing root reconstruction or the composite graft-valve replacement is still the first choice of treatment for these patients? |
title | Surgery of the aortic root: should we go for the valve-sparing root
reconstruction or the composite graft-valve replacement is still the first choice of
treatment for these patients? |
title_full | Surgery of the aortic root: should we go for the valve-sparing root
reconstruction or the composite graft-valve replacement is still the first choice of
treatment for these patients? |
title_fullStr | Surgery of the aortic root: should we go for the valve-sparing root
reconstruction or the composite graft-valve replacement is still the first choice of
treatment for these patients? |
title_full_unstemmed | Surgery of the aortic root: should we go for the valve-sparing root
reconstruction or the composite graft-valve replacement is still the first choice of
treatment for these patients? |
title_short | Surgery of the aortic root: should we go for the valve-sparing root
reconstruction or the composite graft-valve replacement is still the first choice of
treatment for these patients? |
title_sort | surgery of the aortic root: should we go for the valve-sparing root
reconstruction or the composite graft-valve replacement is still the first choice of
treatment for these patients? |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4541781/ https://www.ncbi.nlm.nih.gov/pubmed/26313725 http://dx.doi.org/10.5935/1678-9741.20150028 |
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