Early and long-term outcome in patients undergoing aortic root replacement with composite graft according to the Bentall's technique

Massimo Massetti, Edvin Prifti, Massimo Bonacchi, Giacomo Frati, Piero Proietti, Gabriele Giunti, Gerard Babatasi, Guido Sani

Risultato della ricerca: Contributo in rivistaArticolo in rivista

43 Citazioni (Scopus)

Abstract

OBJECTIVE: The aims of this study were: (i) to evaluate the early and long-term outcome in patients undergoing aortic root replacement (ARR) with a composite graft; (ii) to identify the predictors for poor overall survival in this pool of patients. MATERIAL AND METHODS: Between January 1989 and December 2000, 212 patients underwent ARR with a CG. Mean age was 56+/-14 years, ranging from 16 to 77. Annuloaortic ectasia was the most frequent cause of aortic disease in this series, 81 (38%) patients, followed by atherosclerotic aneurysm 57 (27%) and type A acute aortic dissection 52 (24.5%). Marfan's syndrome was present in 37 (17.5%) patients. Duration of follow-up ranged from 1 to 120 months, mean 59+/-35 months. RESULTS: The overall hospital mortality was 16 (7.5%) patients. Eight of them had aortic dissection and four Marfan syndrome. The most frequently found complication resulted to be renal failure in 22 (10%) patients and low cardiac output in 15 (7%) patients. The incidence of perioperative myocardial infarction, neurological complications, respiratory complications, renal failure and coagulopathy incidence were significantly higher in patients with cardiopulmonary bypass (CPB) time >170 min, CA >40 min, and total aortic arch replacement. The actuarial survival at 1, 3 and 5 years resulted to be 91.8, 86 and 81.5%, instead the actuarial survival without re-operation resulted to be 89, 82 and 78%. The actuarial survival in patients with aortic dissection was significantly lower versus non-dissection (P=0.022). The multivariate analysis revealed the aortic dissection (P=0.03), age >65 years (P=0.014), associated coronary artery disease (P=0.002), NYHA functional class>/=3 (P=0.027), LVEF <35% (P=0.002) and total arch reconstruction (P=0.003) as strong predictors for poor overall survival in patients undergoing ARR. CONCLUSIONS: The ARR with a CG offers acceptable early and long-term outcome. The predictors for poor overall survival in patients undergoing ARR seems to be preoperative aortic dissection extended into the aortic arch, older age, depressed left ventricular function and associated coronary artery disease.
Lingua originaleEnglish
pagine (da-a)15-21
Numero di pagine7
RivistaEuropean Journal of Cardio-thoracic Surgery
Volume21
Stato di pubblicazionePubblicato - 2002

Keywords

  • Adolescent
  • Adult
  • Aged
  • Aortic Diseases
  • Blood Vessel Prosthesis Implantation
  • Female
  • Heart Valve Prosthesis Implantation
  • Humans
  • Hypothermia, Induced
  • Male
  • Middle Aged
  • Mitral Valve Insufficiency
  • Prognosis
  • Survival Analysis
  • Treatment Outcome
  • Vascular Surgical Procedures

Fingerprint Entra nei temi di ricerca di 'Early and long-term outcome in patients undergoing aortic root replacement with composite graft according to the Bentall's technique'. Insieme formano una fingerprint unica.

Cita questo