초록접수 현황
| 15F-048 | 포럼 발표 |
Reopertaive Aortic Root Replacement in Patients with Previous Aortic Root Procedures
정병권, 정성호, 주석중, 정철현, 이재원, 김준범
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
Background : Generalization of standardized surgical techniques to treat aortic valve (AV) and aortic root diseases have benefitted large numbers of patients. By the accumulation of patients receiving aortic root surgeries, surgeons are more frequently challenged by patients who require reoperative root replacement these days. This aim of this study is to evaluate outcomes of reoperative aortic root procedure.
Methods : We retrospectively reviewed 66 patients (36 men; mean age, 44.5±9.5 years) who underwent reoperative aortic root replacement between April 1995 and June 2015 following surgeries of AV or aortic root procedures.
Results : Numbers of previous cardiac operations were one in 53 patients (80.3%), two in 11 (16.7%) and three or more in 2 (3.0%). Emergent surgeries comprised 43.9% (n=29). Indications for the reoperative root replacement were aneurysm (n=12), pseudoaneurysm (n=1) or dissection (n=6) of residual native aortic sinus in 19 patients (28.8%), native AV dysfunction in 8 (12.1%), structural dysfunction of implanted bioprosthetic AV in 19 (28.8%) and infection of previously replaced AV or proximal aortic grafts in 30 (45.5%). Concomitant arch repair was undertaken in 14 patients (21.2%) while additional 11 patients required circulatory arrest during reoperative root replacement. There were 3 early deaths (4.5%). During follow-up (median, 37.3 months; quartile 1-3, 9.5-68.3 months), there were 14 late deaths (21.2%) and 13 valve-related complications including reoperation in 5, infective endocarditis in 3 and hemorrhagic events in 5. Overall survival and event-free survival rates at 5 years were 79.2±5.8% and 73.9±6.2%, respectively.
Conclusion : Despite technical challenges and a high rate of emergent conditions in patients requiring reoperative aortic root replacement, early and late outcomes following were acceptable in these patients.
Methods : We retrospectively reviewed 66 patients (36 men; mean age, 44.5±9.5 years) who underwent reoperative aortic root replacement between April 1995 and June 2015 following surgeries of AV or aortic root procedures.
Results : Numbers of previous cardiac operations were one in 53 patients (80.3%), two in 11 (16.7%) and three or more in 2 (3.0%). Emergent surgeries comprised 43.9% (n=29). Indications for the reoperative root replacement were aneurysm (n=12), pseudoaneurysm (n=1) or dissection (n=6) of residual native aortic sinus in 19 patients (28.8%), native AV dysfunction in 8 (12.1%), structural dysfunction of implanted bioprosthetic AV in 19 (28.8%) and infection of previously replaced AV or proximal aortic grafts in 30 (45.5%). Concomitant arch repair was undertaken in 14 patients (21.2%) while additional 11 patients required circulatory arrest during reoperative root replacement. There were 3 early deaths (4.5%). During follow-up (median, 37.3 months; quartile 1-3, 9.5-68.3 months), there were 14 late deaths (21.2%) and 13 valve-related complications including reoperation in 5, infective endocarditis in 3 and hemorrhagic events in 5. Overall survival and event-free survival rates at 5 years were 79.2±5.8% and 73.9±6.2%, respectively.
Conclusion : Despite technical challenges and a high rate of emergent conditions in patients requiring reoperative aortic root replacement, early and late outcomes following were acceptable in these patients.
책임저자: 김준범
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
연락처 : 정병권, Tel: 010-4210-5101 , E-mail : pogri@naver.com
