| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 2001;71:1460-1463
© 2001 The Society of Thoracic Surgeons
a Division of Cardiovascular Surgery, Toronto General Hospital, and University of Toronto, Toronto, Ontario, Canada
Accepted for publication December 14, 2000.
Address reprint requests to Dr David, 200 Elizabeth St, 13EN-219, Toronto, Ontario M5G 2C4, Canada
e-mail: tirone.david{at}uhn.on.ca
Background. Aortic root re-replacement is being performed with increased frequency. Limited information is available regarding the surgical approaches and clinical outcomes of this reoperation.
Methods. Between May 1980 and May 1999, 31 patients (mean age, 45 ± 15 years) underwent redo composite replacement of the aortic valve and ascending aorta. Indications for reoperation were prosthetic valve endocarditis in 12 patients (39%), failed biological valve in 17 (55%), and false aneurysm in 2 (6%). At reoperation, mechanical valves were implanted in 24 patients and biologic valves in 7. All patients with endocarditis had annular abscess and required reconstruction of the left ventricular outflow tract before implantation of a new valved conduit. Mechanical valves were used in 24 patients, aortic homograft in 4, and bioprosthetic valves in 3. The coronary button technique was used to reimplant the coronary arteries whenever possible. Extension of one or both coronary arteries with a short segment of saphenous vein or a synthetic graft was used in 16 patients (52%). The aortic arch was replaced in 7 patients (23%).
Results. There was one operative death (3%) because of rupture of an abdominal aortic aneurysm. The mean follow-up was 47 ± 46 months and was 100% complete. There were five late deaths (16%), three of which were cardiac related. The actuarial survival was 71% ± 12% at 5 years. Three patients experienced recurrent prosthetic valve endocarditis 4 months to 8 years after operation. The 8-year freedom from endocarditis for patients operated on for endocarditis was 82% ± 11% compared with 100% for those operated on for other reasons (p = 0.1). At the last follow-up, 21 of 25 survivors (84%) were in New York Heart Association functional classes I or II, and 4 were in class III.
Conclusions. Redo aortic root replacement can be performed with good early and late results. Patients operated on for prosthetic root endocarditis may have an increased risk of recurrent late endocarditis.
This article has been cited by other articles:
|
|
 |
|
  G. Krasopoulos, T. E. David, and S. Armstrong Custom-tailored valved conduit for complex aortic root disease J. Thorac. Cardiovasc. Surg., January 1, 2008; 135(1): 3 - 7. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. C. Stamou, G. Petterson, and A. M. Gillinov Surgical Treatment of Mitral Valve Endocarditis Card. Surg. Adult, January 1, 2008; 3(2008): 1069 - 1078. [Full Text]
|
|
|
|
 |
|
 W. Y. Szeto, J. E. Bavaria, F. W. Bowen, A. Geirsson, K. Cornelius, W. C. Hargrove, and A. Pochettino Reoperative Aortic Root Replacement in Patients With Previous Aortic Surgery Ann. Thorac. Surg., November 1, 2007; 84(5): 1592 - 1599. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. A. LeMaire and J. S. Coselli Options for managing infected ascending aortic grafts. J. Thorac. Cardiovasc. Surg., October 1, 2007; 134(4): 839 - 843. [Full Text] [PDF]
|
|
|
|
|
|
M. A. Borger, K. Prasongsukarn, S. Armstrong, C. M. Feindel, and T. E. David Stentless Aortic Valve Reoperations: A Surgical Challenge Ann. Thorac. Surg., September 1, 2007; 84(3): 737 - 744. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. F. Coutinho and M. J. Antunes Pseudoaneurysm of an Aortic Homograft Ann. Thorac. Surg., December 1, 2006; 82(6): 2280 - 2282. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Aortic root replacement after previous surgical intervention on the aortic valve, aortic root, or ascending aorta. J. Thorac. Cardiovasc. Surg., March 1, 2006; 131(3): 601 - 608.
|
|
|
|
|
|
P. M. Davierwala, M. A. Borger, T. E. David, V. Rao, M. Maganti, and T. M. Yau Reoperation is not an independent predictor of mortality during aortic valve surgery J. Thorac. Cardiovasc. Surg., February 1, 2006; 131(2): 329 - 335. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Mahesh, G. Angelini, M. Caputo, X. Y. Jin, and A. Bryan Prosthetic Valve Endocarditis Ann. Thorac. Surg., September 1, 2005; 80(3): 1151 - 1158. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Sioris, T. E. David, J. Ivanov, S. Armstrong, and C. M. Feindel Clinical outcomes after separate and composite replacement of the aortic valve and ascending aorta J. Thorac. Cardiovasc. Surg., August 1, 2004; 128(2): 260 - 265. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. A. LeMaire, D. J. DiBardino, C. Koksoy, and J. S. Coselli Proximal aortic reoperations in patients with composite valve grafts Ann. Thorac. Surg., November 1, 2002; 74(5): S1777 - 1780. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. B. Mitchell, D. N. Campbell, D. A. Bishop, T. Mackenzie, and D. R. Clarke Surgical options and results of repeated aortic root replacement for failed aortic allografts placed in childhood J. Thorac. Cardiovasc. Surg., September 1, 2002; 124(3): 459 - 470. [Abstract] [Full Text] [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 |
