Objective: Valve-sparing root replacement is commonly used for
management of aortic root aneurysms in elective setting, but its
technical complexity hinders its broader adoption for acute Type-A
Aortic Dissection (ATAAD). The Florida Sleeve (FS) procedure is a
simplified form of valve sparing aortic root reconstruction that does
not require coronary reimplantation. Here, we present our outcomes of
the Florida Sleeve (FS) repair in patients with dilated roots in the
setting of an ATAAD. Methods: We retrospectively reviewed 24 consecutive
patients (2002-2018) treated with FS procedure for ATAAD. Demographic,
operative, and postoperative outcomes were queried from our
institutional database. Long term follow-up was obtained from clinic
visits for local patients, and with telephone and telehealth measures
otherwise. Results: Mean age was 49 ± 14 years with 19 (79%) males.
Marfan syndrome was present in 4 (16.7%) patients and 14 (58.3) had ≥2+
aortic insufficiency (AI). Nine (37.2%) had preoperative mal-perfusion
or shock. The FS was combined with hemi-arch replacement in 15 (62.5%)
patients and a zone-2 arch replacement in 9 (37.5%) patients. There
were 2 (8.3%) early postoperative mortalities. Median follow-up period
was 46 months (range; 0.3-146). The median survival of the entire cohort
was 143.4 months. One patient (4.2%) required redo aortic valve
replacement for unrelated aortic valve endocarditis at 30 months
postoperatively. Conclusion: FS is simplified and reproducible
valve-sparing root repair. In appropriate patients, it can be applied
safely in acute Stanford type-A aortic dissection with excellent early
and long-term results.
Valve-sparing aortic root replacement can be done safely and effectively in acute type A aortic dissection