Influence of technique of coronary artery implantation on long-term results in composite aortic root replacement.

Abstract

BACKGROUND:

Long-term results after composite graft aortic root replacement may depend on the insertion technique. The aim of this study is to assess the influence of the technique of coronary artery implantation on long-term results in composite aortic root replacement.

METHODS:

One hundred fifty consecutive patients (mean age, 55 years; 119 men) with different disorders of the ascending aorta who underwent aortic root replacement with a composite graft prosthesis between January 1985 and December 1999 were retrospectively studied. Thirteen patients had previously undergone cardiovascular surgery. The open button technique was performed in 65 patients (43.3%, group 1) and the inclusion technique in 85 patients (56.7%, group 2). Mean follow-up was 70.5 months. Surgery was elective in 110 procedures (73%).

RESULTS:

Global actuarial survival was 76.1% +/- 4.3% for group 1 and 73.7% +/- 3.9% for group 2 at 10 years (p = 0.22). Freedom from reoperation excluding early deaths was 81% +/- 3% for group 1 and 86% +/- 2.2% for group 2 at 10 years (p = 0.62). Group 2 demonstrated a statistically significantly higher occurrence of pseudoaneurysm formation versus group 1 (p = 0.04).

CONCLUSIONS:

Composite graft aortic root replacement is a safe and effective therapy for proximal aortic aneurysm and dissection, resulting in good early and long-term results irrespective of the anastomotic technique. However, the open button technique seems to avoid late false aneurysm formation at the anastomotic sites.

• Authors: A Panos, B Amahzoune, J Robin, G Champsaur, J Ninet
• Journal: The Annals of thoracic surgery (Ann Thorac Surg) Vol. 72 Issue 5 Pg. 1497-501 (Nov 2001) ISSN: 0003-4975 [Print] Netherlands
• PMID: 11722032 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Aortic Valve
• Coronary Vessels (surgery)
• Female
• Follow-Up Studies
• Heart Valve Prosthesis
• Heart Valve Prosthesis Implantation (methods)
• Humans
• Male
• Middle Aged
• Postoperative Complications (mortality)
• Prosthesis Design
• Retrospective Studies
• Survival Rate
• Time Factors