| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 1993;55:1513-1517
© 1993 The Society of Thoracic Surgeons
Department of Cardiac and Thoracic Surgery and Department of Cardiology, Hôpital Henri Mondor, Créteil, France
Accepted for publication September 28, 1992.
* Address reprint requests to Dr Mazzucotelli, Service de Chirurgie Cardiaque, Hôpital Henri Mondor, 51, Av Delattre de Tassigny, 94010, Créteil Cedex, France.
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. Severe aortic insufficiency developed in 7 patients in the years after operation, and 6 of them underwent reoperation for prosthetic valve replacement. Echocardiographic findings were judged to show no or mild residual aortic insufficiency in 22 patients and moderate aortic insufficiency with satisfactory left ventricular function in 12 (2 patients had aortic valve replacement because of concomitant mitral valve disease or coronary disease). In all, late aortic valve replacement was realized in 8 patients at a mean interval of 61.5 ± 51.2 months after the first operation. Actuarial freedom from aortic valve replacement was 83% ± 6% at 5 years and 79% ± 7% at 10 and 15 years. This study emphasizes the benefit of surgical procedures that preserve the aortic valve and aortic root in the repair of acute aortic dissection involving the ascending aorta, without additional risk of recurrent aortic insufficiency.
This article has been cited by other articles:
|
|
 |
|
  American College of Cardiology Foundation, American Heart Association Task Force on Practice, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interve, Society of Interventional Radiology, Society of Thoracic Surgeons, Society for Vascular Medicine, et al. 2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease J. Am. Coll. Cardiol., April 6, 2010; 55(14): e27 - e129. [Full Text] [PDF]
|
|
|
|
 |
|
 WRITING GROUP MEMBERS, L. F. Hiratzka, G. L. Bakris, J. A. Beckman, R. M. Bersin, V. F. Carr, D. E. Casey Jr, K. A. Eagle, L. K. Hermann, E. M. Isselbacher, et al. 2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, and Society for Vascular Medicine Circulation, April 6, 2010; 121(13): e266 - e369. [Full Text] [PDF]
|
|
|
|
 |
|
 P. D. Patel and R. R. Arora Pathophysiology, diagnosis, and management of aortic dissection Therapeutic Advances in Cardiovascular Disease, December 1, 2008; 2(6): 439 - 468. [Abstract] [PDF]
|
|
|
|
 |
|
 F. Farhat, M. Durand, L. Boussel, I. Sanchez, J. Villard, and O. Jegaden Should a reimplantation valve sparing procedure be done systematically in type A aortic dissection? Eur J Cardiothorac Surg, January 1, 2007; 31(1): 36 - 41. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Trimarchi, C. A. Nienaber, V. Rampoldi, T. Myrmel, T. Suzuki, R. H. Mehta, E. Bossone, J. V. Cooper, D. E. Smith, L. Menicanti, et al. Contemporary results of surgery in acute type A aortic dissection: The International Registry of Acute Aortic Dissection experience J. Thorac. Cardiovasc. Surg., January 1, 2005; 129(1): 112 - 122. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Kallenbach, T. Oelze, R. Salcher, C. Hagl, M. Karck, R. G. Leyh, and A. Haverich Evolving Strategies for Treatment of Acute Aortic Dissection Type A Circulation, September 14, 2004; 110(11_suppl_1): II-243 - II-249. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. T. Lai, D. C. Miller, R. S. Mitchell, P. E. Oyer, K. A. Moore, R. C. Robbins, N. E. Shumway, and B. A. Reitz Acute type a aortic dissection complicated by aortic regurgitation: composite valve graft versus separate valve graft versus conservative valve repair J. Thorac. Cardiovasc. Surg., December 1, 2003; 126(6): 1978 - 1985. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. G. Leyh, S. Fischer, K. Kallenbach, T. Kofidis, K. Pethig, W. Harringer, and A. Haverich High Failure Rate After Valve-sparing Aortic Root Replacement Using the "Remodeling Technique" in Acute Type A Aortic Dissection Circulation, September 24, 2002; 106(12_suppl_1): I-229 - I-233. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Kirsch, C. Soustelle, R. Houel, M. L. Hillion, and D. Loisance Risk factor analysis for proximal and distal reoperations after surgery for acute type A aortic dissection J. Thorac. Cardiovasc. Surg., February 1, 2002; 123(2): 318 - 325. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. H. Mehta, T. Suzuki, P. G. Hagan, E. Bossone, D. Gilon, A. Llovet, L. C. Maroto, J. V. Cooper, D. E. Smith, W. F. Armstrong, et al. Predicting Death in Patients With Acute Type A Aortic Dissection Circulation, January 15, 2002; 105(2): 200 - 206. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Murashita, T. Kunihara, N. Shiiya, H. Aoki, K. Myojin, and K. Yasuda Is preservation of the aortic valve different between acute and chronic type A aortic dissections? Eur J Cardiothorac Surg, November 1, 2001; 20(5): 967 - 972. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Kazui, N. Washiyama, Abul Hasan Muhammad Bashar, H. Terada, K. Suzuki, K. Yamashita, and M. Takinami Role of biologic glue repair of proximal aortic dissection in the development of early and midterm redissection of the aortic root Ann. Thorac. Surg., August 1, 2001; 72(2): 509 - 514. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. R. Moon, T. M. Sundt III, M. K. Pasque, H. B. Barner, C. B. Huddleston, R. J. Damiano Jr, and W. A. Gay Jr Does the extent of proximal or distal resection influence outcome for type A dissections? Ann. Thorac. Surg., April 1, 2001; 71(4): 1244 - 1249. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. P. Graeter, F. Langer, N. Nikoloudakis, D. Aicher, and H.-J. Schafers Valve-preserving operation in acute aortic dissection type A Ann. Thorac. Surg., November 1, 2000; 70(5): 1460 - 1465. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Hirotani, T. Kameda, T. Kumamoto, and S. Shirota Results of a total aortic arch replacement for an acute aortic arch dissection J. Thorac. Cardiovasc. Surg., October 1, 2000; 120(4): 686 - 691. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. P. Casselman, M. E. S.H. Tan, F. E.E. Vermeulen, J. C. Kelder, W. J. Morshuis, and M. A.A.M. Schepens Durability of aortic valve preservation and root reconstruction in acute type A aortic dissection Ann. Thorac. Surg., October 1, 2000; 70(4): 1227 - 1233. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. D. Movsowitz, R. A. Levine, A. D. Hilgenberg, and E. M. Isselbacher Transesophageal echocardiographic description of the mechanisms of aortic regurgitation in acute type A aortic dissection: implications for aortic valve repair J. Am. Coll. Cardiol., September 1, 2000; 36(3): 884 - 890. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. G. Leyh, C. Schmidtke, C. Bartels, and H.-H. Sievers Valve-sparing aortic root replacement (remodeling/reimplantation) in acute type A dissection Ann. Thorac. Surg., July 1, 2000; 70(1): 21 - 24. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. F. Sabik, B. W. Lytle, E. H. Blackstone, P. M. McCarthy, F. D. Loop, and D. M. Cosgrove Long-term effectiveness of operations for ascending aortic dissections J. Thorac. Cardiovasc. Surg., May 1, 2000; 119(5): 946 - 962. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Pessotto, F. Santini, P. Pugliese, G. Montalbano, G. B. Luciani, G. Faggian, P. Bertolini, and A. Mazzucco Preservation of the aortic valve in acute type A dissection complicated by aortic regurgitation Ann. Thorac. Surg., June 1, 1999; 67(6): 2010 - 2013. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Pugliese, R. Pessotto, F. Santini, G. Montalbano, G. B. Luciani, and A. Mazzucco Risk of late reoperations in patients with acute type A aortic dissection: impact of a more radical surgical approach Eur J Cardiothorac Surg, May 1, 1998; 13(5): 576 - 581. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Westaby, T. Katsumata, and E. Freitas Aortic Valve Conservation in Acute Type A Dissection Ann. Thorac. Surg., October 1, 1997; 64(4): 1108 - 1112. [Abstract] [Full Text]
|
|
|
|
|
|
L. K. von Segesser, E. Lorenzetti, M. Lachat, U. Niederhauser, M. Schonbeck, P. R. Vogt, and M. I. Turina AORTIC VALVE PRESERVATION IN ACUTE TYPE A DISSECTION: IS IT SOUND? J. Thorac. Cardiovasc. Surg., February 1, 1996; 111(2): 381 - 391. [Abstract] [Full Text]
|
|
|
|
|
|
J. R. Seguin, E. Picard, J.-M. Frapier, and P.-A. Chaptal Aortic valve repair with fibrin glue for type a acute aortic dissection Ann. Thorac. Surg., August 1, 1994; 58(2): 304 - 307. [Abstract] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
