Analysis of aortic root surgery with composite mechanical aortic valve conduit and valve-sparing reconstruction [Análise do tratamento cirúrgico da raiz da aorta com o tubo valvulado e com a preservação da valvaaórtica]
Dias R.R.,General Cardiac Surgical Unit |
Mejia O.A.V.,InCor FMUSP |
Fiorelli A.I.,General Cardiac Surgical Unit |
Pomerantzeff P.M.A.,Heart Valve Surgery Unit |
And 3 more authors.
Brazilian Journal of Cardiovascular Surgery | Year: 2010
Objective: Comparative analysis of early and late results of aortic root reconstruction with aortic valve sparing operations and the composite mechanical valve conduit replacement. Methods: From November 2002 to September 2009, 164 consecutive patients with mean age 54 ± 15 years, 115 male, underwent the aortic root reconstruction (125 mechanical valve conduit replacements and 39 valve sparing operations). Sixteen percent of patients had Marfan syndrome and 4.3% had bicuspid aortic valve. One hundred and forty-four patients (88%) were followed for a mean period of 41.1 ± 20.8 months. Free of complications such as bleeding, thromboembolism nd endocarditis were favorable to the valve sparing operations, respectively (95% CI = 70% - 95%, P = 0.001), (95% CI = 82% - 95% P = 0.03) and (95% CI = 81% - 95%, P = 0.03). Multivariate analysis showed that creatinine greater than 1.4 mg/dl, Cabrol operation and renal dialysis were predictors of mortality, respectively, with occurrence chance of 6 (95% CI = 1.8 - 19.5, P = 0.003), 12 (95% CI = 3 - 49.7, P = 0.0004) and 16 (95% CI = 3.6 - 71.3, P = 0.0002). Conclusions: The aortic root reconstruction has a low early and late mortality, high survival free of complications and low need for reoperation. During the late follow-up, valve sparing aortic root reconstructions presented fewer incidences of bleeding, thromboembolic events and endocarditis.