Brazilian single-center experience with aortic root replacement in 448 patients: what is the best technique?
Rev. bras. cir. cardiovasc
;
35(6): 869-877, Nov.-Dec. 2020. tab, graf
Article
in English
| LILACS, SES-SP
| ID: biblio-1143995
ABSTRACT
Abstract Introduction:
The objective of this study was to evaluate whether a surgery with the use of valved conduit is capable of leading to better immediate and late results than those obtained by the valve-sparing aortic root reconstruction technique.Methods:
Between January 2002 and June 2016, 448 patients underwent aortic root reconstruction. These were divided into three groups according to the technique used 319 (71.2%) patients received mechanical valved conduits, 49 (10.9%) received biological valved conduits, and 80 (17.9%) underwent the valve-sparing aortic root reconstruction technique. The results were examined by univariate and multivariate analyses of Cox proportional hazards models with multiple logistic regression.Results:
The hospital mortality rate was 7.5%. The mortality rates were 8.2%, 12%, and 2.5% in the mechanical valved conduit, biological valved conduit, and aortic valve-sparing groups, respectively, with no significant difference between groups (P=0.1). Thromboembolic complications and reoperation-free survival were also similar (P=0.169 and P=0.688). However, valve-sparing aortic root replacement was superior in terms of long-term survival (P<0.001), hemorrhagic-free survival (P<0.001), and endocarditis-free survival (P=0.048). Multivariate analysis showed that the following aspects had an impact on mortality age > 70 years (P<0.001; hazard ratio [HR] 1.05), preoperative acute kidney injury (P<0.0042; HR 2.9), diagnosis of dissection (P<0.01; HR 2.0), previous cardiac surgery (P<0.027; HR 2.3), associated coronary artery bypass grafting (P<0.038; HR 1.8), reoperation for postoperative tamponade (P<0.004; HR 2.2) and postoperative acute kidney injury (P<0.02; HR 3.35).Conclusion:
Valve-sparing technique seems to be the operation of choice, whenever possible, for aortic root reconstruction.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Aortic Valve
/
Heart Valve Prosthesis Implantation
Type of study:
Observational study
/
Risk factors
Limits:
Humans
/
Male
Country/Region as subject:
South America
/
Brazil
Language:
English
Journal:
Rev. bras. cir. cardiovasc
Year:
2020
Type:
Article
Institution/Affiliation country:
Universidade de São Paulo/BR
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