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The Annals of Thoracic Surgery, Vol 55, 1513-1517, Copyright © 1993 by The Society of Thoracic Surgeons
JP Mazzucotelli, PH Deleuze, C Baufreton, AM Duval, ML Hillion, DY Loisance and JP Cachera
The aim of the present study was to determine the long-term status of the
native aortic valve after surgical treatment of acute aortic dissection
involving the ascending aorta. From 1972 to 1991, 93 patients underwent
operation for type I or II aortic dissection. There were 76 men and 17
women. Mean age was 54 +/- 13 years. Eighty patients (86%) had a
conservative procedure regarding the aortic root and aortic cusps: 74 had
prosthetic replacement of the ascending aorta and 6, complete replacement
of the aortic arch. Thirteen patients (14%) had simultaneous replacement of
the aortic valve and the ascending aorta. The overall hospital mortality
rate was 29% (27/93). The overall actuarial survival rate was 60.2% +/-
5.2%, 49.7% +/- 6.1%, and 35.9% +/- 8.1% at 5, 10, and 15 years,
respectively. The survival rates for patients who had an ascending aortic
procedure only were 63% +/- 5.5%, 54% +/- 6.5%, and 39% +/- 8.5% at 5, 10,
and 15 years, respectively, and for patients who required aortic valve
replacement, 45% +/- 14% and 22% +/- 17.5% at 5 and 10 years, respectively.
Fifty long-term survivors (94% follow-up) with preservation of the aortic
valve and aortic root were studied. Among them, 9 (18%) died within a mean
interval of 97 +/- 46 months after operation. Causes of death were ischemic
cardiac failure (2), aortic rupture or extension of dissection (4), renal
disease (1), stroke (1), and sudden death (1). Forty-one patients had
long-term clinical and echocardiographic evaluation.(ABSTRACT TRUNCATED AT
250 WORDS)
ARTICLES
Preservation of the aortic valve in acute aortic dissection: long-term echocardiographic assessment and clinical outcome
Department of Cardiac and Thoracic Surgery, Hopital Henri Mondor, Creteil, France.
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