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14:14
Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
Published on: December 11, 2017
Redo aortic valve surgery: early and late outcomes
Sergey Leontyev1, Michael A Borger, Piroze Davierwala
1Department of Cardiac Surgery, Heart Center, University of Leipzig, Leipzig, Germany. serg_leontyev@web.de
The Annals of Thoracic Surgery
|February 1, 2011
Summary
Repeat isolated aortic valve surgery (rAVS) offers respectable outcomes, with good long-term survival demonstrated in patients undergoing this complex procedure. Key predictors for mortality include low ejection fraction and preoperative neurologic dysfunction.
Area of Science:
- Cardiovascular Surgery
- Cardiac Surgery Outcomes
- Aortic Valve Replacement
Background:
- Repeat aortic valve surgery (rAVS) carries increased risks due to patient age and comorbidities.
- This study evaluates early and late outcomes of isolated rAVS.
Purpose of the Study:
- To analyze the early and late results of isolated repeat aortic valve surgery.
- To identify predictors of in-hospital and long-term mortality after rAVS.
Main Methods:
- Retrospective analysis of 155 patients undergoing isolated rAVS between November 1994 and April 2008.
- Patients were divided into two groups: isolated redo aortic valve surgery (rAVS without root) and aortic root replacement (rAVS with root).
- Multivariate and Cox regression analyses were used to identify predictors of mortality and survival.
Main Results:
- Early mortality was 4.5%, with no significant difference between surgical groups.
- Independent predictors for in-hospital mortality included left ventricular ejection fraction < 0.30 and preoperative neurologic dysfunction.
- Five-year and eight-year survival rates were 66% and 61%, respectively.
- Preoperative New York Heart Association functional class IV and infective endocarditis were independent predictors of long-term survival.
Conclusions:
- Isolated repeat aortic valve surgery is associated with acceptable early and late outcomes.
- Long-term survival after rAVS is good, with specific patient factors influencing prognosis.
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