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Repeat aortic root replacement

C Hahn1, S K Tam, G J Vlahakes

  • 1Cardiac Surgical Unit, Massachusetts General Hospital, Harvard Medical School, Boston, USA.

The Annals of Thoracic Surgery
|August 6, 1998
PubMed
Summary
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Repeat aortic root replacement is technically challenging but achievable with low mortality, even for patients with endocarditis. This study highlights successful reoperations for aortic root repair.

Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Aortic Surgery

Background:

  • Repeat aortic root replacement poses significant technical challenges and may increase surgical mortality.
  • Previous aortic root replacement techniques included homograft, bioprosthetic, and mechanical valve composite grafts.
  • Reoperations were primarily indicated for pseudoaneurysm formation and endocarditis.

Purpose of the Study:

  • To evaluate the safety and efficacy of repeat aortic root replacement procedures.
  • To assess outcomes in patients undergoing reoperation for aortic root pathology.

Main Methods:

  • A retrospective review of seven consecutive patients undergoing eight repeat aortic root replacements from January 1989 to November 1995.
  • All reoperations utilized the coronary button technique.

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  • Follow-up averaged 19 months.

    • Main Results:

    • No early deaths occurred; one late death was recorded at 16 months post-operation.
    • Aortic homografts were used for endocarditis cases, while mechanical valve composite grafts were used for others.
    • One patient experienced recurrent endocarditis requiring a second successful homograft replacement.

    Conclusions:

    • Repeat aortic root replacement can be performed with low mortality, even in the presence of endocarditis.
    • The coronary button technique is a viable approach for repeat aortic root replacement.