Outcomes of the modified Cabrol technique in aortic root replacement: Early and midterm experience

The modified Cabrol technique has been associated with excellent graft patency. However, prior studies were limited to patients largely on long-term anticoagulation. We sought to analyze outcomes in patients primarily managed without mechanical prostheses.

We retrospectively analyzed all patients who underwent aortic root replacement by a single surgeon from 2014 to 2024. Patients who underwent reimplantation of one or both coronary ostia using the modified Cabrol technique with separate interposition grafts were identified. Baseline characteristics and postoperative outcomes were reported. Predictors of mortality were analyzed using Cox proportional hazards, and overall survival was reported using Kaplan-Meier analysis.

We identified 91 patients who underwent the modified Cabrol technique. The median age was 62 [interquartile range, 52-71] years, and 91.2% (83/91) were male. Patients presented urgently or emergently in 38.5% (35/91) of cases, and for acute dissection in 23.1% (21/91) of cases, and endocarditis in 15.4% (14/91). Patients required redo sternotomy in 50% of cases. A mechanical composite valve graft was used in only 7.7% (7/91) of patients. The incidence of long-term myocardial infarction was 4.4% (4/91). Survival at 1 and 5 years was 93% and 89% respectively. There was no significant association with the utilization of Cabrol graft and long-term mortality (Hazard Ratio 1.74, 95% CI 0.76-4.01, p-value 0.219).

Patients undergoing the modified Cabrol technique had an acceptable risk of mortality in short- and midterm follow-up. The modified Cabrol technique is a valuable tool in an aortic surgeon's arsenal and should be used selectively.