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Aortic root replacement: twenty years of experience
G Casali1, G B Luciani, P Pugliese
1Cattedra di Cardiochirurgia, Università degli Studi, Verona.
Giornale Italiano Di Cardiologia
|October 17, 1998
Summary
Aortic root replacement surgery shows decreasing early mortality and good long-term survival, making it a safe and effective treatment. Biologic substitutes offer comparable results to composite grafts for all patient age groups.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Surgical Outcomes
Background:
- Aortic root replacement is a complex procedure with evolving techniques.
- Assessing outcomes of aortic root replacement over two decades is crucial for understanding its efficacy.
Purpose of the Study:
- To evaluate the early and long-term outcomes of aortic root replacement procedures.
- To compare the effectiveness of different surgical techniques and graft materials.
Main Methods:
- A retrospective review of 156 aortic root replacement operations performed between 1979 and 1997.
- Analysis of patient demographics, diagnoses, surgical techniques (Bentall, modified Bentall, Cabrol), and graft types (biologic substitutes).
- Mean follow-up of 41 months, ranging up to 18 years.
Main Results:
- Overall hospital mortality was 7.6%, significantly higher in emergent cases (22%) versus elective (5%).
- Modified Bentall and biologic root techniques showed favorable mortality rates (5% and 3%, respectively).
- Long-term survival rates were 78% at 5 years and 71% at 10 years; reoperation and valve complications increased after 10 years.
Conclusions:
- Aortic root replacement is a low-risk, effective, and durable treatment with decreasing early mortality.
- Biologic substitutes enable the procedure for all age groups, yielding results comparable to composite grafts.
- Satisfying late results support aortic root replacement as a standard surgical option.