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Ann Thorac Surg 1999;68:1676-1680
© 1999 The Society of Thoracic Surgeons
a Department of Cardiothoracic Surgery, St Antonius Hospital, Nieuwegein, The Netherlands
Address reprints requests to Dr Schepens, Department of Cardiothoracic Surgery, St Antonius Hospital, Koekoekslaan 1, CM Nieuwegein, The Netherlands
e-mail: marc.schepens{at}worldonline.nl
Background. This analysis was performed to evaluate the results of reoperations on the ascending aorta and aortic root.
Methods. All reoperations (n = 134) on the aortic root and ascending aorta performed between February 1981 and April 1998 were retrospectively analyzed. Indications for reintervention were a true or false aneurysm (35%), acute dissection (3.0%), aortic valve stenosis and/or insufficiency (23.1%), prosthetic valve endocarditis (32.8%), and combinations (4.5%). The principal reoperations performed were aortic root replacement (composite graft, freestyle, aortic allograft, or pulmonary autograft) in 116 patients, ascending aortic replacement in 10 patients, and closure of a false aneurysm in 5 patients. Results were analyzed using univariate statistical methods.
Results. Hospital mortality was 6.6% (8 patients). Univariate predictors of hospital death were preoperative functional class III or IV (p = 0.02), an interval of less than 6 months between the primary and actual operation (p = 0.02), preoperative creatinine level of more than 200 µmol/L (p = 0.001), acute aortic dissection (p = 0.001), intraoperative technical problems (p = 0.001), and postoperative dialysis (p = 0.001). Freedom from repetitive reoperation was 99% at 1 year and 98% at 5 and 10 years.
Conclusions. Reoperations on the aortic root and ascending aorta can be performed with an early mortality which is very acceptable.
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