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Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
Published on: December 11, 2017
Long term results with the Cabrol aortic root replacement
Tadashi Kitamura1, Ikutaro Kigawa, Sachito Fukuda
1Department of Cardiovascular Surgery, Mitsui Memorial Hospital, Tokyo, Japan.
Insights
The Cabrol aortic root replacement shows favorable early and late outcomes, but careful follow-up is crucial due to potential coronary complications. This study evaluates the procedure
Area of Science:
- Cardiovascular Surgery
- Aortic Surgery
- Surgical Outcomes
Background:
- Cabrol aortic root replacement is infrequently performed due to concerns about coronary complications.
- Evaluating the long-term efficacy and safety of the Cabrol procedure is essential.
Purpose of the Study:
- To assess the early and late results of Cabrol aortic root replacement.
- To specifically investigate the incidence and impact of coronary complications.
Main Methods:
- Retrospective review of 36 patients undergoing Cabrol aortic root replacement (1988-2001).
- Analysis of early mortality, late deaths, survival rates, and reoperation rates.
- Coronary ostia assessment via angiography or CT in 18 patients post-operation.
Main Results:
- Low early mortality (2.8%) and acceptable late survival (83.3% at 5 years, 72.9% at 10 years).
- High freedom from reoperation on the ascending aorta (87.9% at 5 years, 76.6% at 10 years).
- Two cases of right coronary ostium stenosis or occlusion identified late post-operatively.
Conclusions:
- The Cabrol operation demonstrates favorable early and late results, with low mortality and reoperation rates.
- Coronary complications remain a significant concern, necessitating vigilant long-term patient monitoring.
Abstract:
Cabrol aortic root replacement is rarely performed in recent years because of potential coronary complications. The purpose of this study was to investigate its early and late results, including coronary complications, by evaluating our experience thus far. A retrospective lookup of patients who underwent Cabrol aortic root replacement between 1988 and 2001 found a total of 36 patients (24 men and 12 women) with a mean age of 45 years. Annuloaortic ectasia was the most frequent cause (n = 22), followed by chronic dissection (n = 5), acute dissection (n = 5), and aneurysm with prior aortic operation (n = 4). Early mortality occurred in one patient (2.8%). The mean follow-up period was 104 months. There were 7 late deaths, 4 of which were disease-related. The actuarial survival was 83.3% at 5 years and 72.9% at 10 years, and the freedom from reoperation was 87.9% at 5 years and 76.6% at 10 years. There were no reoperations on the ascending aorta. Coronary ostia were examined by angiography or 64-row multidetector computed tomography in 18 patients 43 to 189 months after the operation. Two patients developed stenosis or occlusion of the right coronary ostium. The early and late results of the Cabrol operation were favorable with the exception of coronary complications. The importance of careful follow-up for late coronary complications cannot be overemphasized.
