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Related Experiment Videos

Reoperations on the aortic root and ascending aorta

D Dougenis1, B B Daily, N T Kouchoukos

  • 1Division of Cardiothoracic Surgery, Washington University School of Medicine, and the Heart Center, Missouri Baptist Medical Center, BJC Health System, St. Louis, USA.

The Annals of Thoracic Surgery
|November 14, 1997
PubMed
Summary

Reoperations on the aortic root and ascending aorta offer acceptable early mortality and good long-term survival. Early resection of aortic disease may decrease future reoperation needs.

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Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Aortic Surgery

Background:

  • Reoperations on the aortic root and ascending aorta are increasingly common and technically demanding.
  • Previous operations in this cohort included aortic valve procedures, coronary artery bypass grafting, and aortic replacements.

Purpose of the Study:

  • To evaluate the outcomes of reoperations on the aortic root and ascending aorta.
  • To identify predictors of early and late mortality after these complex procedures.

Main Methods:

  • Eighty-one patients underwent reoperations for aneurysms, dissections, or valve issues.
  • Procedures included aortic root replacement (48 patients) and ascending aorta replacement (33 patients).
  • Concomitant aortic arch replacement and coronary artery bypass grafting were frequently performed.

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Main Results:

  • The 30-day mortality was 8.6%, with preoperative functional class and bypass duration predicting early death.
  • Long-term survival rates at 1, 5, and 10 years were 89%, 81%, and 69%, respectively.
  • Reoperation for aneurysm and concomitant coronary artery bypass grafting predicted late mortality.

Conclusions:

  • Reoperations on the aortic root and ascending aorta are feasible with acceptable early mortality.
  • Satisfactory long-term survival rates can be achieved.
  • Proactive resection during initial operations may reduce the need for future reoperations.