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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
Summary
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.
- 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.