[Early and late results of composite graft replacement for the aortic root]

From 1985 to 1998, 16 patients underwent composite graft replacement for the aortic root. Ten patients (63%) had Marfan syndrome, 11 (69%) had annulo aortic ectasia (AAE), and 7 (44%) had Stanford A dissection. Two patients (12.5%) underwent emergent operation due to acute aortic dissection. There were 2 (12.5%) operative deaths, and both were Stanford A dissection without Marfan syndrome. Although there was no statistical significance, the operative mortality was higher for the patients with Stanford A dissection (p = 0.087), for those with emergent operation (p = 0.074) and for those without Marfan syndrome (p = 0.051). The overall survival rates were 87.5% at 5 years and 75% at 10 years. The survival rate at 8 years was significantly lower for the patients with Stanford A dissection (35.7%) as compared with non-Stanford A dissection (100%, p = 0.024). Neither Marfan syndrome nor AAE affected the long-term survival. The late results of composite graft replacement for the aortic root were satisfactory except for the patients with Stanford A dissection. It was suggested that the long-term survival for Stanford A dissection was greately affected by the operative deaths for Stanford A dissection without Marfan syndrome.