Faculty Collaboration Database

Efficacy of Aortic Valve Resuspension in Establishing Valve Competence in Acute Type A Dissections. Ann Thorac Surg 2017 May;103(5):1460-1466

Date

11/20/2016

Pubmed ID

27863732

DOI

10.1016/j.athoracsur.2016.08.099

Scopus ID

2-s2.0-85006717893 (requires institutional sign-in at Scopus site)   16 Citations

Abstract

BACKGROUND: This study investigates the efficacy of aortic valve (AV) resuspension with preservation of the native aortic root in maintaining AV competence during type A dissection repair.

METHODS: A total of 154 acute type A dissection repairs were performed from January 2000 to July 2015. AV resuspension was performed in 120 patients to address AV insufficiency (AI). Survival data were derived from 120 patients who had AV resuspensions and all 154 acute type A dissection repairs.

RESULTS: Of the 70 patients who presented initially with moderate-to-severe AI, 43 underwent AV resuspension. Echocardiographic data for analysis were available in 40 of these 43 patients. In the group with moderate-to-severe AI at presentation, AV resuspension was able to achieve mild or less AI in 38 of 40 patients (95%) and trivial or no AI in 29 of 40 patients (73%) after weaning from cardiopulmonary bypass. The presence of moderate-to-severe preoperative AI did not predict the ability to achieve trivial or no AI with resuspension immediately after coming off cardiopulmonary bypass (p = 0.3) or on subsequent follow-up (p = 0.8). Mean echocardiographic follow-up for AV resuspension was 1.21 ± 2.57 years. Three patients who underwent AV resuspension required AV reoperation at follow-up. There was no survival difference between patients who did or did not have AV resuspension (p = 0.3).

CONCLUSIONS: AV resuspension is able to improve valve competency with good outcomes even in patients with moderate or severe AI at presentation. Overall long-term survival is unchanged compared with other operative strategies for the AV.

Author List

Tang PC, Badami A, Akhter SA, Osaki S, Lozonschi L, Kohmoto T, De Oliveira N

Author

Takushi Kohmoto MD, PhD Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Aortic Aneurysm, Thoracic
Aortic Valve
Echocardiography, Transesophageal
Female
Follow-Up Studies
Heart Valve Diseases
Heart Valve Prosthesis Implantation
Humans
Male
Middle Aged
Postoperative Complications
Risk Factors
Survival Rate
Tomography, X-Ray Computed
Treatment Outcome