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[Clinical study of re-do surgery after Bentall-type operation]
1Department of Cardiovascular Surgery, National Cardiovascular Center, Osaka, Japan.
[Zasshi] [Journal]. Nihon Kyobu Geka Gakkai
|May 1, 1996
Summary
Reoperations for composite graft complications after aortic root repair are uncommon but serious. Graft infection carries a poor prognosis, emphasizing infection prevention and addressing sutural insufficiency in aortitis patients.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Surgical Pathology
Context:
- Bentall-type procedure using composite grafts for aortic root reconstruction is a standard surgical approach.
- A cohort of 155 patients undergoing aortic root reconstruction between 1978 and December 1994 were analyzed.
- Indications for the procedure included annulo-aortic ectasia, aortic dissection, and aortitis.
Purpose:
- To investigate the incidence and management of complications requiring reoperation after composite graft aortic root reconstruction.
- To evaluate the outcomes of reoperations for specific complications such as graft infection, pseudoaneurysm, and prosthetic valve failure.
- To identify factors influencing prognosis and suggest preventive strategies.
Summary:
- A total of 13 out of 155 patients (8.4%) required reoperation for composite graft-related complications.
- Early complications included graft infection (4 patients), with high mortality despite intervention.
- Late complications involved pseudoaneurysm (4 patients) and prosthetic valve failure (7 patients), with favorable outcomes after reoperation, except for graft infection.
Impact:
- Graft infection post-composite aortic root reconstruction is associated with a poor prognosis, highlighting the critical importance of infection prevention.
- Sutural insufficiency leading to pseudoaneurysm formation necessitates robust surgical techniques and potentially further countermeasures, especially in patients with aortitis.
- Late reoperations for pseudoaneurysm and prosthetic valve failure after Bentall procedures can yield favorable results, offering viable solutions for long-term patient management.