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Twenty-four year experience with reoperations after ascending aortic or aortic root replacement.

K M Dossche1, M E Tan, M A Schepens

  • 1Department of Cardiothoracic Surgery, St. Antonius Hospital, Nieuwegein, The Netherlands. dossche@planet.nl

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|January 27, 2000
PubMed
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Late reoperations for ascending aorta or aortic root issues, often due to false aneurysms, show low hospital mortality and good long-term survival. These complex aortic surgeries yield favorable outcomes despite risks. Keywords: aortic reoperation, ascending aorta, aortic root, aneurysm.

Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Aortic Surgery

Background:

  • Late reoperations for ascending aorta or aortic root replacement are complex procedures.
  • Indications include false aneurysm (44.6%) and true aneurysm (32.1%).

Purpose of the Study:

  • To analyze early and late outcomes of late reoperations (>4 weeks) on the ascending aorta or aortic root.
  • To identify risk factors for mortality in these reoperations.

Main Methods:

  • Retrospective analysis of 56 patients undergoing reoperation for ascending aorta or aortic root replacement over 24 years.
  • Follow-up data was collected to assess survival and event-free survival.

Main Results:

  • Hospital mortality was 5.4%, with risk factors including multiple previous operations and short interval to reoperation.

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  • Independent risk factor for hospital death was operation for active endocarditis or graft infection (odds 14.6).
  • Estimated 5-year survival was 84.0%, with 5-year event-free survival at 72.2%.

    • Conclusions:

    • False aneurysm and aneurysm progression are primary drivers for late reoperations.
    • Reoperations on the ascending aorta and aortic root can be performed with acceptable hospital mortality and favorable long-term results.