초록접수 현황
| 20F-116 | 구연 발표 |
Comparisons of long-term results of concomitant ascending aorta surgery for patients with aortic valve disease and borderline ascending aorta aneurysm: Replacement versus Suture reduction
Jae Woong Choi, Kyung Hwan Kim, Suk Ho Sohn, Ho Young Hwang
Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
Purpose : This study was conducted to compare the long-term results between concomitant ascending aorta replacement(AAR) and suture reduction of ascending aorta(SRA) for patients with aortic valve disease and borderline ascending aorta aneurysm(40mm≤size<55mm).
Methods : Between 2000 and 2016, 276 patients(ascending aortic diameter=45.4±3.9mm) with moderate to severe or severe aortic valve disease underwent concomitant ascending aorta surgery for borderline ascending aorta aneurysm. SRA was performed in 141 patients and AAR was performed in 135 patients. Propensity score-matched analysis was performed, and 84 patients were extracted from each group.
Results : Operative mortality (n=7, 2.5%) and postoperative complications were similar between the two groups before and after matching. The aortic cross-clamp time was significantly longer in AAR group than in SRA group before (ARR: 151±37 min; SRA; 104±44 min, p <0.001) and after matching (ARR: 160±51min; SRA; 99±147min, p <0.001). Overall survival at 5 and 10 years were 86.2% and 79.7%, respectively, without intergroup differences (p=0.121). Major adverse aortic events(MAE) occurred in 5 patients(sudden death: 4 patients, dissection:1 patient), and the freedom from MAE at 5 and 10 years were 98.5% and 97.4%, respectively, without an intergroup difference(p = 0.695). In matched patients, there were no significant differences in overall survival and MAE between two groups (p=0.317, p=0.564, respectively).
Conclusion : Concomitant SRA and AAR showed comparable long-term clinical results for patients with severely diseased aortic valve and borderline ascending aorta aneurysm. Considering the shorter ACC time in SRA group, concomitant SRA can be an effective alternative option for surgically high-risk patients with borderline ascending aorta aneurysm.
Methods : Between 2000 and 2016, 276 patients(ascending aortic diameter=45.4±3.9mm) with moderate to severe or severe aortic valve disease underwent concomitant ascending aorta surgery for borderline ascending aorta aneurysm. SRA was performed in 141 patients and AAR was performed in 135 patients. Propensity score-matched analysis was performed, and 84 patients were extracted from each group.
Results : Operative mortality (n=7, 2.5%) and postoperative complications were similar between the two groups before and after matching. The aortic cross-clamp time was significantly longer in AAR group than in SRA group before (ARR: 151±37 min; SRA; 104±44 min, p <0.001) and after matching (ARR: 160±51min; SRA; 99±147min, p <0.001). Overall survival at 5 and 10 years were 86.2% and 79.7%, respectively, without intergroup differences (p=0.121). Major adverse aortic events(MAE) occurred in 5 patients(sudden death: 4 patients, dissection:1 patient), and the freedom from MAE at 5 and 10 years were 98.5% and 97.4%, respectively, without an intergroup difference(p = 0.695). In matched patients, there were no significant differences in overall survival and MAE between two groups (p=0.317, p=0.564, respectively).
Conclusion : Concomitant SRA and AAR showed comparable long-term clinical results for patients with severely diseased aortic valve and borderline ascending aorta aneurysm. Considering the shorter ACC time in SRA group, concomitant SRA can be an effective alternative option for surgically high-risk patients with borderline ascending aorta aneurysm.
책임저자: Kyung Hwan Kim
Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
발표자: 최재웅, E-mail : woong3537@hanmail.net