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Aortic root replacement with composite valve graft.

Davide Pacini1, Federico Ranocchi, Emanuela Angeli

  • 1Department of Cardiac Surgery, University of Bologna, Bologna, Italy. dpacini@hotmail.com

The Annals of Thoracic Surgery
|July 5, 2003
PubMed
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Composite valve graft replacement for aortic root and ascending aorta conditions shows low mortality. The button technique is preferred, and early intervention is crucial for Marfan syndrome patients to prevent dissection.

Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Aortic Surgery

Background:

  • Composite valve graft replacement is a primary treatment for aortic root and ascending aorta diseases.
  • This study details the authors' experience with aortic root replacement using composite grafts.

Purpose of the Study:

  • To evaluate the outcomes of composite valve graft replacement for aortic root and ascending aorta lesions.
  • To identify risk factors for mortality and reoperation.
  • To compare different surgical techniques.

Main Methods:

  • A retrospective analysis of 274 patients undergoing composite graft replacement of the aortic root between 1978 and 2001.
  • Patients had conditions including annuloaortic ectasia and aortic dissection.
  • Surgical techniques included the Bentall, button, and Cabrol methods.

Related Experiment Videos

Main Results:

  • Early mortality was 6.9%. Independent risk factors for early death included prolonged cardiopulmonary bypass and concurrent coronary artery bypass grafting.
  • Actuarial survival rates were 77.7% at 5 years and 63% at 10 years.
  • Independent risk factors for late mortality included coronary artery disease, chronic renal failure, and dialysis. Freedom from reoperation was higher in non-Marfan patients.

Conclusions:

  • Composite valve graft replacement is associated with low hospital mortality and morbidity.
  • The button technique offers advantages and should be prioritized.
  • Early root replacement is recommended for Marfan patients before dissection; it's often unnecessary for acute aortic dissection.