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Surgical management of aortic root abscess
1Division of Cardiovascular Surgery, University of Toronto, Ontario, Canada.
Journal of Cardiac Surgery
|March 1, 1997
Summary
Radical resection of aortic root abscess using pericardium is effective for infection eradication. However, patients face a high risk of recurrent endocarditis, necessitating careful follow-up.
Area of Science:
- Cardiac Surgery
- Infectious Disease
- Cardiovascular Research
Background:
- Aortic root abscess surgery has high reported mortality and morbidity.
- This study reviews experience with radical abscess resection and left ventricular outflow tract reconstruction.
Purpose of the Study:
- To evaluate the efficacy of radical aortic root abscess resection and pericardial reconstruction.
- To assess outcomes, including survival and recurrent endocarditis rates.
Main Methods:
- Review of 63 consecutive patients undergoing aortic root abscess surgery since 1980.
- Surgical technique involved radical resection and reconstruction using pericardium, with prosthetic valves used in most cases.
- Analysis of perioperative complications, mortality, and long-term follow-up data.
Main Results:
- Eight perioperative deaths and 26 non-fatal complications occurred.
- Ten-year actuarial survival was 55% ± 10%, with 55% ± 10% freedom from late death.
- Freedom from recurrent endocarditis at 10 years was 75% ± 8%, with nine late recurrences.
Conclusions:
- Radical resection of aortic root abscess and reconstruction with pericardium effectively eradicates infection.
- Patients treated for aortic root abscess have a significant risk of late recurrent endocarditis.