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Related Experiment Videos

Redo aortic root replacement: experience with 31 patients.

E Raanani1, T E David, G Dellgren

  • 1Division of Cardiovascular Surgery, Toronto General Hospital, and University of Toronto, Ontario, Canada.

The Annals of Thoracic Surgery
|June 1, 2001
PubMed
Summary

Redo aortic root replacement offers good outcomes, but patients with endocarditis face higher recurrent infection risks. This study details surgical approaches and clinical results for this complex reoperation.

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Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Cardiac Surgery

Background:

  • Aortic root re-replacement procedures are increasingly common.
  • Limited data exists on surgical techniques and outcomes for aortic root reoperations.

Purpose of the Study:

  • To evaluate the surgical approaches and clinical outcomes of redo aortic root replacement.
  • To assess early and late results, including survival and functional status.

Main Methods:

  • Retrospective analysis of 31 patients undergoing redo composite aortic valve and ascending aorta replacement (1980-1999).
  • Indications included prosthetic valve endocarditis (39%), failed bioprosthetic valve (55%), and false aneurysm (6%).
  • Surgical techniques involved mechanical or biologic valves, coronary reimplantation, and aortic arch replacement in select cases.

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Main Results:

  • One operative death (3%); 5 late deaths (16%), 3 cardiac-related.
  • Actuarial survival was 71% at 5 years, with 84% of survivors in NYHA functional class I or II.
  • Recurrent prosthetic valve endocarditis occurred in 3 patients; 8-year freedom from endocarditis was 82% for those operated on for endocarditis.

Conclusions:

  • Redo aortic root replacement can be achieved with favorable early and late clinical outcomes.
  • Patients reoperated on for prosthetic root endocarditis have a higher risk of recurrent infection.