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Aortic root surgery: early postoperative results of different surgical techniques

Benetis, Rimantas ; Ereminiene, Egle ; Jakuska, Povilas ; Karciauskas, Dainius ; Kinduris, Sarūnas ; Budrikis, Algimantas ; Siudikas, Adakrius ; Vaskelyte, Jolanta Justina ; Sasnauskas, Algimantas ; Sakalauskas, Juozas ; Vaiciulis, Kastytis

Medicina (Kaunas, Lithuania), 2009, Vol.45 (3), p.197-202 [Peer Reviewed Journal]

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Title:
Aortic root surgery: early postoperative results of different surgical techniques
Author: Benetis, Rimantas ; Ereminiene, Egle ; Jakuska, Povilas ; Karciauskas, Dainius ; Kinduris, Sarūnas ; Budrikis, Algimantas ; Siudikas, Adakrius ; Vaskelyte, Jolanta Justina ; Sasnauskas, Algimantas ; Sakalauskas, Juozas ; Vaiciulis, Kastytis
Subjects: Data Interpretation, Statistical ; Age Factors ; Hospital Mortality ; Aortic Aneurysm - mortality ; Humans ; Middle Aged ; Risk Factors ; Aortic Aneurysm - surgery ; Heart Valve Prosthesis Implantation - mortality ; Male ; Treatment Outcome ; Blood Vessel Prosthesis Implantation - mortality ; Time Factors ; Aneurysm, Dissecting - surgery ; Aorta - surgery ; Aortic Valve Insufficiency - surgery ; Coronary Artery Bypass ; Female ; Aged ; Aortic Valve Insufficiency - mortality ; Postoperative Complications ; Aneurysm, Dissecting - mortality ; Index Medicus
Is Part Of: Medicina (Kaunas, Lithuania), 2009, Vol.45 (3), p.197-202
Description: The aim of the study was to evaluate early postoperative results of different surgical techniques of aortic root surgery. Between January 2004 and November 2007, a cohort of 83 patients underwent aortic root surgery in the Heart Center, Hospital of Kaunas University of Medicine. Patients were divided into three groups: Group 1 (18 patients) - reimplantation of the aortic valve within a vascular graft (David operation), Group 2 (48 patients) - replacement of the ascending aorta and aortic valve using a valved conduit (Bentall de Bono operation), and Group 3 (17 patients) - biological aortic root replacement. Study protocol included clinical data, operative data, and postoperative major adverse effects: reoperations for bleeding, stroke and lethal outcomes. Patients undergoing biological aortic root replacement were older as compared with other groups. The mean age in the Group 1 was 50.3+/-3.5 years vs. 57+/-2.0 years in the Group 2 and 67.8+/-3.3 years in the Group 3 (P<0.05). The main indication for the aortic root surgery was the aneurysm of the aortic root and ascending aorta in the Group 1 and 2 patients (64.7% and 72%), while in the Group 3, the main indication was fibrocalcinosis of aortic valve, aortic annulus, and ascending aorta (61.1%). The 30-day hospital mortality rates were as follows: 5.8% (n=1), in the Group 1; 10.4% (n=5), in the Group 2; 5.5% (n=1), in the Group 3. In the early postoperative period, 11 reoperations were performed due to bleeding events: in the Group 1, after planned/emergency surgery (n=2/2), and in the Group 2 (n=1/6), respectively. The function of aortic valve improved significantly in all groups of patients early after surgery. In the Group 1, the degree of aortic regurgitation decreased from 2.5+/-0.8 to 1.1+/-0.6 (P<0.05); in the Groups 2 and 3, the mean gradient through the aortic valve decreased from 39.9+/-7.5 to 17.1+/-5.3 mm Hg and from 48.8+/-18.0 to 20.1+/-11.0 mm Hg, respectively (P<0.05). No reoperation for aortic valve failure before the discharge was required in all groups of patients, and neither thromboembolic complications nor stroke events were noted in any group. Different aortic root surgery techniques showed similar postoperative results. New aortic root surgery methods such as aortic root-preserving/sparing procedures and concurrent aortic valve leaflet repair or aortic root replacement with the bioprosthesis can be selected for a diverse class of aortic root pathology with low perioperative mortality rates and good early postoperative results.
Publisher: Switzerland
Language: Lithuanian;English
Identifier: ISSN: 1010-660X
EISSN: 1648-9144
DOI: 10.3390/medicina45030026
PMID: 19357449

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Aortic root surgery: early postoperative results of different surgical techniques

Benetis, Rimantas ; Ereminiene, Egle ; Jakuska, Povilas ; Karciauskas, Dainius ; Kinduris, Sarūnas ; Budrikis, Algimantas ; Siudikas, Adakrius ; Vaskelyte, Jolanta Justina ; Sasnauskas, Algimantas ; Sakalauskas, Juozas ; Vaiciulis, Kastytis

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