scholarly journals Durable results of preserved valve and root after acute type A aortic dissection surgery in bicuspid aortic valve

2022 ◽  
Author(s):  
Tsu-Jui Hsu ◽  
Cheng-Wei Chen ◽  
Ron-Bin Hsu
Keyword(s):  
Aortic Valve ◽  
Aortic Dissection ◽  
Aortic Valve Replacement ◽  
Bicuspid Aortic Valve ◽  
Emergency Surgery ◽  
Type A ◽  
Long Term Results ◽  
Acute Type ◽  
Type A Aortic Dissection

Background and aims of the study. Data on emergency surgery for acute type A aortic dissection in patients with bicuspid aortic valve were limited. Long-term results on the fate of the preserved bicuspid valve and aortic root were even rare. We sought to assess the clinical outcome of emergency acute type A aortic dissection surgery in patients with bicuspid aortic valve. Methods. From 2004 to 2021, 121 patients underwent emergency surgery for acute type A aortic dissection using a conservative aortic resection. Hospital and late outcomes were assessed in patients with bicuspid aortic valve. Results. Eight patients (6.6%) had bicuspid aortic valve with 6 males (75%) and median age of 49.5 years (range, 34 to 71). Four (50%) had significant aortic valve dysfunction. Operation included ascending aortic grafting with aortic valve preservation in 4, ascending aortic grafting with aortic valve replacement in 3 and ascending aortic grafting with Bentall root replacement in 1. Hospital mortality rate was 12.5% (1/8). With a median follow-up of 14.4 years, there was one late death and no proximal reoperation of 6 preserved roots and 3 preserved valves. Median diameter of preserved aortic roots changed from 42 (range, 33-43) to 38.5 mm (range, 35-46) with the average time of 11 years after surgery. Conclusions. Acute type A aortic dissection in bicuspid aortic valve was not associated with worse outcome. Aortic valve replacement was often required. Simultaneous root replacement was not always necessary. Preservation of normally functioning bicuspid valve and non-dilated root showed durable long-term results.

scholarly journals Florida Sleeve is a Safe and Effective Technique for Valve Salvage in Acute Stanford Type A Aortic Dissection

2021 ◽  
Author(s):  
Mahmoud Alhussaini ◽  
Eric Jeng ◽  
Tomas Martin ◽  
Amber Filion ◽  
Thomas Beaver ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Dissection ◽  
Aortic Root ◽  
Type A ◽  
Long Term Results ◽  
Acute Type ◽  
Type A Aortic Dissection ◽  
Valve Sparing

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.

OC20 EARLY AND LONG-TERM RESULTS OF LATE REOPERATION AFTER REPAIRED ACUTE TYPE A AORTIC DISSECTION

2018 ◽  
Vol 19 ◽  
pp. e2
Author(s):  
D. Piani ◽  
I. Vendramin ◽  
A. Lechiancole ◽  
V. Ferrara ◽  
M. Meneguzzi ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Type A ◽  
Long Term Results ◽  
Acute Type ◽  
Type A Aortic Dissection

scholarly journals Acute type A aortic dissection: long-term results and reoperations

2012 ◽  
Vol 43 (2) ◽  
pp. 389-396 ◽  
Author(s):  
Jos A. Bekkers ◽  
Goris Bol Raap ◽  
Johanna J.M. Takkenberg ◽  
Ad J.J.C. Bogers
Keyword(s):  
Aortic Dissection ◽  
Type A ◽  
Long Term Results ◽  
Acute Type ◽  
Type A Aortic Dissection

Age-related presentation of acute type A aortic dissection

2018 ◽  
Vol 26 (9) ◽  
pp. 659-666 ◽  
Author(s):  
Pietro Giorgio Malvindi ◽  
Daniela Votano ◽  
Ahmed Ashoub ◽  
Amit Modi ◽  
Szabolcs Miskolczi ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Connective Tissue ◽  
Aortic Dissection ◽  
Bicuspid Aortic Valve ◽  
Type A ◽  
Acute Type ◽  
Connective Tissue Disorders ◽  
Type A Aortic Dissection ◽  
Younger Patients ◽  
Intimal Tear

Background We evaluated the clinical and anatomic presentations of acute type A aortic dissection according to patient age. Methods We retrospectively reviewed 235 consecutive patients who underwent acute type A dissection repair between January 2000 and December 2014. The influence of age on anatomical and clinical presentation, surgical management in the entire cohort and also after exclusion of patients with known connective tissue disorders was assessed using logistic regression. Results Males presented with type A acute aortic dissection at a younger age than females. Acute onset with signs of myocardial ischemia, connective tissue disorders, or bicuspid aortic valve characterized the younger population. Extension to the coronary sinus(es) ( p = 0.0003), descending thoracic aorta ( p = 0.016), and abdominal aorta ( p = 0.029), and an intimal tear at the level of the aortic root ( p = 0.0017) correlated inversely with patient age. Similar findings were obtained after exclusion of patients with connective tissue disorders or a bicuspid aortic valve. Conclusions More frequent proximal and distal progression of the dissection flap occurs in younger patients with acute type A aortic dissection. Older age is associated with a lower probability of an intimal tear at the level of the sinus of Valsalva. These findings, associated with prognostic implications, account for the choice of more radical proximal procedures for repair of aortic dissection in younger patients.

The significance of bicuspid aortic valve after surgery for acute type A aortic dissection

2020 ◽  
Vol 159 (3) ◽  
pp. 760-767.e3 ◽  
Author(s):  
Ari Mennander ◽  
Christian Olsson ◽  
Anders Jeppsson ◽  
Arnar Geirsson ◽  
Vibeke Hjortdal ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Dissection ◽  
Bicuspid Aortic Valve ◽  
Type A ◽  
Acute Type ◽  
Type A Aortic Dissection
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