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Takahiro Katsumata
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Ann Thorac Surg 1997;64:1108-1112
© 1997 The Society of Thoracic Surgeons

Original Article: Cardiovascular

Aortic Valve Conservation in Acute Type A Dissection

Stephen Westaby, FRCS, Takahiro Katsumata, MD, Edward Freitas, MD

Department of Cardiac Surgery, Oxford Heart Centre, Oxford, England

Accepted for publication April 23, 1997.

Background. We consider operative survival as the primary objective in acute type A dissection and believe that virtually all native aortic valves can be conserved. We sought to answer the question: "Does glue repair improve the long-term stability of proximal aortic repair?"

Methods. We retrospectively studied 64 patients with an acute type A dissection, an ascending aortic tear, and aortic regurgitation operated on by the same surgeon between 1988 and 1996. Three had Marfan's syndrome and 2 had a bicuspid valve. The valves in all patients without Marfan's syndrome were repaired with gelatin-resorcinol-formol glue. The valve and root were reinvestigated by echocardiography. Some patients underwent nuclear magnetic resonance imaging.

Results. There were four hospital (6%) and three late deaths. Aortic root reoperation was required in 2 of the 60 survivors (3.3%) and operation on the distal aorta in 2. Root reoperations were required within 3 years. The remaining proximal repairs remained stable.

Conclusions. The native aortic valve can be conserved in most patients, and glue repair is durable. Simple root repair is associated with a low operative mortality.




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