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14:14
Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
Published on: December 11, 2017
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Aortic root remodelling with external ring annuloplasty in acute type A aortic dissection
Yasuyuki Kato1, Kenichi Sasaki1, Hidetaka Yamauchi1
1Department of Cardiovascular Surgery, Saitama Sekishinkai Hospital, Saitama, Japan.
Interactive Cardiovascular and Thoracic Surgery
|October 10, 2019
Summary
Aortic root remodelling with external ring annuloplasty shows promising early and mid-term results for acute type A aortic dissection. This valve-sparing technique may be suitable for younger patients requiring aortic repair.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Aortic Surgery
Background:
- Acute type A aortic dissection is a life-threatening condition requiring prompt surgical intervention.
- Traditional surgical approaches for aortic dissection may involve aortic valve replacement, impacting long-term outcomes.
- Valve-sparing aortic root remodelling aims to preserve native aortic valve function.
Purpose of the Study:
- To evaluate the early and mid-term clinical outcomes of valve-sparing aortic root remodelling using external ring annuloplasty in patients with acute type A aortic dissection.
- To assess the safety and efficacy of this technique in a specific cohort of patients.
Main Methods:
- Retrospective analysis of 18 patients undergoing aortic root remodelling with external ring annuloplasty for acute type A aortic dissection between January 2015 and April 2019.
- Evaluation of perioperative data, including concomitant procedures and malperfusion.
- Assessment of early (30-day) and mid-term (mean 56 months) outcomes, including mortality and aortic regurgitation, via echocardiography.
Main Results:
- The study included 18 patients (mean age 49 years; 78% male), with 5 having Marfan syndrome and 2 a bicuspid aortic valve.
- The 30-day mortality rate was 5.6%. Postoperative echocardiography revealed minimal aortic regurgitation (<1+) in all patients.
- During a mean follow-up of 56 months, one patient required aortic valve replacement for recurrent aortic regurgitation.
Conclusions:
- Aortic root remodelling with external ring annuloplasty demonstrates favorable early and mid-term results in selected patients with acute type A aortic dissection.
- This valve-sparing approach may be a viable option for younger or middle-aged patients with acute type A aortic dissection, potentially preserving native valve function.
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