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Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
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Early and Late Outcomes After Complete Aortic Replacement

Anthony L Estrera1, Harleen K Sandhu1, Rana O Afifi1

  • 1Department of Cardiothoracic and Vascular Surgery, Clinical Science Program, The University of Texas Medical School at Houston and Memorial Hermann Hospital, Houston, Texas.

The Annals of Thoracic Surgery
|June 14, 2015
PubMed

Insights

Complete aortic replacement is feasible with acceptable outcomes, though often requiring multiple stages, particularly in younger patients with aortic dissection. This study provides valuable data for future comparisons with emerging endovascular techniques.

Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Vascular Surgery

Background:

  • Analysis of a 20-year experience with total aortic replacement.
  • Focus on complex aortic pathologies requiring extensive surgical intervention.

Purpose of the Study:

  • To evaluate the outcomes of complete aortic replacement over two decades.
  • To analyze patient demographics, procedural characteristics, and long-term survival.

Main Methods:

  • Retrospective review of 39 patients undergoing complete aortic replacement between 1991 and 2013.
  • Categorization of procedures based on aortic segments repaired (proximal/distal to left subclavian artery).
  • Staged repair approach utilized when feasible for extensive aortic disease.

Main Results:

  • 87 operations performed on 39 patients, with a median completion time of 8.7 months.
  • 54% of patients required two or more stages for complete aortic replacement.
  • No early deaths; 6% paraplegia after distal repairs. 20-year survival was 30%.

Conclusions:

  • Complete aortic replacement is achievable with acceptable morbidity and mortality.
  • Younger patients with aortic dissection frequently require multi-stage repairs.
  • This data serves as a benchmark for advancing endovascular aortic repair techniques.
Abstract

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