OC38 LONG-TERM OUTCOME AFTER BENTALL OPERATION AND VALVE SPARING AORTIC ROOT REPLACEMENT IN ELECTIVE PATIENTS

Abstract OBJECTIVES The goal of this study was to report the long-term outcomes of patients with Marfan syndrome who had aortic surgery on any aortic segment except for the replacement of the aortic root itself. METHODS An observational retrospective single-centre study was conducted with 115 Marfan syndrome patients who underwent 189 major aortic interventions from 1995 until 2018. Patients without aortic root replacement were identified and aortic root growth was analysed over time. RESULTS Eleven of 115 patients (9.5%) did not have aortic root replacement during a follow-up of 10.5 [standard deviation (SD) 5.7] years and a mean age at last follow-up of 53.9 (SD 13.4) years. Patients without root replacement did not suffer less frequently from any type of acute aortic dissection (type A 27% vs 25%, P = 0.999; type B 36% vs 25%, P = 0.474). Patients with native aortic roots did not undergo fewer aortic interventions than those with aortic root replacement [12/11, mean 1.09 (SD 0.54) operations/patient vs 177/104, mean 1.7 (SD 1.3); P = 0.128]. Progression of the aortic root dimension was 0.5 (SD 0.3) mm/year in the group of patients with native aortic roots. CONCLUSIONS Current data suggest that 10% of patients with Marfan syndrome with previous aortic surgery will be free from aortic root replacement until the sixth decade of life.

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Long-Term Outcome after Aortic Valve-Sparing Root Surgery in Patients with Connective Tissue Disorder

10.1055/s-0040-1705407 ◽

2020 ◽

Author(s):

J. Petersen ◽

D. Gaekel ◽

E. Girdauskas ◽

H. Reichenspurner ◽

C. Detter

Keyword(s):

Aortic Valve ◽

Connective Tissue ◽

Connective Tissue Disorder ◽

Term Outcome ◽

Long Term Outcome ◽

Valve Sparing

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Aortic valve-sparing root replacement in patients with bicuspid aortic valve: long-term outcome with the David I procedure over 20 years

European Journal of Cardio-Thoracic Surgery ◽

10.1093/ejcts/ezaa083 ◽

2020 ◽

Vol 58 (1) ◽

pp. 86-93 ◽

Cited By ~ 3

Author(s):

Erik Beckmann ◽

Andreas Martens ◽

Heike Krüger ◽

Wilhelm Korte ◽

Tim Kaufeld ◽

...

Keyword(s):

Aortic Valve ◽

Bicuspid Aortic Valve ◽

Aortic Valves ◽

Term Outcome ◽

Long Term Outcome ◽

Initial Surgery ◽

Bicuspid Aortic Valves ◽

Valve Sparing

Abstract OBJECTIVES Aortic valve-sparing root replacement is an excellent treatment option for patients with intact tricuspid aortic valves. However, the durability in patients with bicuspid aortic valves is still a matter of debate. The aim of this study was to analyse the short- and long-term outcomes in patients with bicuspid aortic valves. METHODS Between July 1993 and October 2015, a total of 582 patients underwent the David I procedure, 50 of whom had a bicuspid aortic valve. In these patients, the mean age was 46 ± 13 years, and 80% (n = 40) were men. Follow-up was complete for 100% of patients and comprised a total of 552 patient-years with a mean follow-up time of 11 ± 5.2 years. RESULTS In addition to the David procedure, cusp plication was performed in 34% (n = 17) of patients and commissure repair in 8% (n = 4) of patients. There were no in-hospital deaths, and 1 patient (2%) had a perioperative stroke. The 1-, 5-, 10- and 20-year survival rates of patients after discharge were 98%, 94%, 88% and 84%, respectively. The rates for freedom from valve-related reoperation at 1, 5, 10 and 20 years after initial surgery were 98%, 88%, 79% and 74%, respectively. Long-term freedom from reoperation was comparable to that of patients with tricuspid aortic valves (P = 0.2). CONCLUSIONS The David procedure has excellent short-term results in patients with a bicuspid aortic valve. In this study, the long-term durability of reimplanted bicuspid aortic valves was comparable to that of tricuspid valves. However, careful patient selection might have contributed to this, and further studies might be needed to definitely clarify this issue.

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Long-Term Outcome of Aortic Root Remodeling for Patients With and Without Acute Aortic Dissection

Circulation Journal ◽

10.1253/circj.cj-17-0182 ◽

2017 ◽

Vol 81 (12) ◽

pp. 1824-1831 ◽

Cited By ~ 5

Author(s):

Takashi Kunihara ◽

Niklas Neumann ◽

Steffen Daniel Kriechbaum ◽

Ryota Nomura ◽

Hans-Joachim Schäfers

Keyword(s):

Aortic Dissection ◽

Aortic Root ◽

Acute Aortic Dissection ◽

Term Outcome ◽

Long Term Outcome ◽

Aortic Root Remodeling

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LONG-TERM OUTCOMES AND AORTIC VALVE MOTION AFTER REIMPLANTATION TECHNIQUES OF VALVE SPARING AORTIC ROOT REPLACEMENT, USING GRAFTS WITH PSEUDOSINUSES OF VALSALVA

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(16)32201-x ◽

2016 ◽

Vol 67 (13) ◽

pp. 2200

Author(s):

Haruo Yamauchi ◽

Kan Nawata ◽

Tomoko Nakao ◽

Masao Daimon ◽

Takayuki Kawata ◽

...

Keyword(s):

Aortic Valve ◽

Aortic Root ◽

Aortic Root Replacement ◽

Long Term Outcomes ◽

Valve Motion ◽

Valve Sparing

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Long Term Results of Valve Sparing Aortic Root Replacement; A Single Center Experience

Journal of the American College of Cardiology ◽

10.1016/j.jacc.2013.08.307 ◽

2013 ◽

Vol 62 (18) ◽

pp. C100

Author(s):

Şahin Şenay ◽

Ahmet Ümit Güllü ◽

Aleks Değirmencioğlu ◽

Muharrem Koçyiğit ◽

Eyüp Murat Ökten ◽

...

Keyword(s):

Aortic Root ◽

Aortic Root Replacement ◽

Long Term Results ◽

Single Center ◽

Single Center Experience ◽

Valve Sparing

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Aortic Valve–Sparing Root Replacement (David I Procedure) in Adolescents: Long-Term Outcome

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-0039-1693654 ◽

2019 ◽

Author(s):

Erik Beckmann ◽

Andreas Martens ◽

Heike Krueger ◽

Wilhelm Korte ◽

Tim Kaufeld ◽

...

Keyword(s):

Aortic Valve ◽

Connective Tissue Diseases ◽

Young Patients ◽

Term Outcome ◽

Term Survival ◽

Long Term Outcome ◽

Initial Surgery ◽

Valve Sparing

Introduction Aortic valve-sparing root replacement (David's procedure) is an especially appealing treatment option for young patients. Here, we present the short-, mid, and long-term outcomes of this operation in adolescent patients. Methods Between September 1994 and March 2014, 29 patients aged 6 to 21 years underwent the David-I procedure at our center. We conducted a retrospective study with follow-up. Results The mean age was 16.8 ± 3.4 years and 90% (n = 26) were male. Marfan's syndrome was present in 86% (n = 25) of cases. Ninety-seven percent (n = 28) of cases were performed electively, and one case (3%) was performed emergently for acute aortic dissection type A. There were no early perioperative deaths (0%). Follow-up, which was completed on 100% of patients, comprised a total of 394 patient years and a mean follow-up time of 13.6 ± 5.4 years. The estimates for survival at 1, 5, and 10 years after initial surgery were 100, 97, and 93%, respectively. During follow-up, there were four (14%) late deaths and five (17%) aortic valve-related reoperations. The 1-, 5-, and 10-year estimates for freedom from valve-related reoperation were 100, 86, and 83%, respectively. The perioperative mortality for these five reoperations was 0%. Discussion Aortic valve–sparing root replacement can be performed in adolescents with a very low perioperative risk. Long-term survival seems to be affected by connective tissue diseases.

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