Long-term survival, valve durability, and reoperation for 4 aortic root procedures combined with ascending aorta replacement

Lars G. Svensson; Saila T. Pillai; Jeevanantham Rajeswaran; Milind Y. Desai; Brian Griffin; Richard Grimm; Donald F. Hammer; Maran Thamilarasan; Eric E. Roselli; Gösta B. Pettersson; A. Marc Gillinov; Jose L. Navia; Nicholas G. Smedira; Joseph F. Sabik; Bruce W. Lytle; Eugene H. Blackstone

doi:10.1016/j.jtcvs.2015.10.113

Long-term survival, valve durability, and reoperation for 4 aortic root procedures combined with ascending aorta replacement

Lars G. Svensson, Saila T. Pillai, Jeevanantham Rajeswaran, Milind Y. Desai, Brian Griffin, Richard Grimm, Donald F. Hammer, Maran Thamilarasan, Eric E. Roselli, Gösta B. Pettersson, A. Marc Gillinov, Jose L. Navia, Nicholas G. Smedira, Joseph F. Sabik, Bruce W. Lytle, Eugene H. Blackstone

Research output: Contribution to journal › Article › peer-review

45 Scopus citations

Abstract

Objective To evaluate long-term results of aortic root procedures combined with ascending aorta replacement for aneurysms, using 4 surgical strategies. Methods From January 1995 to January 2011, 957 patients underwent 1 of 4 aortic root procedures: valve preservation (remodeling or modified reimplantation, n = 261); composite biologic graft (n = 297); composite mechanical graft (n = 156); or allograft root (n = 243). Results Seven deaths occurred (0.73%), none after valve-preserving procedures, and 13 strokes (1.4%). Composite grafts exhibited higher gradients than allografts or valve preservation, but the latter 2 exhibited more aortic regurgitation (2.7% biologic and 0% mechanical composite grafts vs 24% valve-preserving and 19% allografts at 10 years). Within 2 to 5 years, valve preservation exhibited the least left ventricular hypertrophy, allograft replacement the greatest; however, valve preservation had the highest early risk of reoperation, allograft replacement the lowest. Patients receiving allografts had the highest risk of late reoperation (P

Original language	English (US)
Pages (from-to)	764-774e4
Journal	Journal of Thoracic and Cardiovascular Surgery
Volume	151
Issue number	3
DOIs	https://doi.org/10.1016/j.jtcvs.2015.10.113
State	Published - Mar 1 2016
Externally published	Yes

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine
Surgery
Pulmonary and Respiratory Medicine

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10.1016/j.jtcvs.2015.10.113

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Svensson, L. G., Pillai, S. T., Rajeswaran, J., Desai, M. Y., Griffin, B., Grimm, R., Hammer, D. F., Thamilarasan, M., Roselli, E. E., Pettersson, G. B., Gillinov, A. M., Navia, J. L., Smedira, N. G., Sabik, J. F., Lytle, B. W., & Blackstone, E. H. (2016). Long-term survival, valve durability, and reoperation for 4 aortic root procedures combined with ascending aorta replacement. Journal of Thoracic and Cardiovascular Surgery, 151(3), 764-774e4. https://doi.org/10.1016/j.jtcvs.2015.10.113

Svensson, LG, Pillai, ST, Rajeswaran, J, Desai, MY, Griffin, B, Grimm, R, Hammer, DF, Thamilarasan, M, Roselli, EE, Pettersson, GB, Gillinov, AM, Navia, JL, Smedira, NG, Sabik, JF, Lytle, BW & Blackstone, EH 2016, 'Long-term survival, valve durability, and reoperation for 4 aortic root procedures combined with ascending aorta replacement', Journal of Thoracic and Cardiovascular Surgery, vol. 151, no. 3, pp. 764-774e4. https://doi.org/10.1016/j.jtcvs.2015.10.113

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abstract = "Objective To evaluate long-term results of aortic root procedures combined with ascending aorta replacement for aneurysms, using 4 surgical strategies. Methods From January 1995 to January 2011, 957 patients underwent 1 of 4 aortic root procedures: valve preservation (remodeling or modified reimplantation, n = 261); composite biologic graft (n = 297); composite mechanical graft (n = 156); or allograft root (n = 243). Results Seven deaths occurred (0.73%), none after valve-preserving procedures, and 13 strokes (1.4%). Composite grafts exhibited higher gradients than allografts or valve preservation, but the latter 2 exhibited more aortic regurgitation (2.7% biologic and 0% mechanical composite grafts vs 24% valve-preserving and 19% allografts at 10 years). Within 2 to 5 years, valve preservation exhibited the least left ventricular hypertrophy, allograft replacement the greatest; however, valve preservation had the highest early risk of reoperation, allograft replacement the lowest. Patients receiving allografts had the highest risk of late reoperation (P ",

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AU - Svensson, Lars G.

AU - Pillai, Saila T.

AU - Rajeswaran, Jeevanantham

AU - Desai, Milind Y.

AU - Griffin, Brian

AU - Grimm, Richard

AU - Hammer, Donald F.

AU - Thamilarasan, Maran

AU - Roselli, Eric E.

AU - Pettersson, Gösta B.

AU - Gillinov, A. Marc

AU - Navia, Jose L.

AU - Smedira, Nicholas G.

AU - Sabik, Joseph F.

AU - Lytle, Bruce W.

AU - Blackstone, Eugene H.

PY - 2016/3/1

Y1 - 2016/3/1

N2 - Objective To evaluate long-term results of aortic root procedures combined with ascending aorta replacement for aneurysms, using 4 surgical strategies. Methods From January 1995 to January 2011, 957 patients underwent 1 of 4 aortic root procedures: valve preservation (remodeling or modified reimplantation, n = 261); composite biologic graft (n = 297); composite mechanical graft (n = 156); or allograft root (n = 243). Results Seven deaths occurred (0.73%), none after valve-preserving procedures, and 13 strokes (1.4%). Composite grafts exhibited higher gradients than allografts or valve preservation, but the latter 2 exhibited more aortic regurgitation (2.7% biologic and 0% mechanical composite grafts vs 24% valve-preserving and 19% allografts at 10 years). Within 2 to 5 years, valve preservation exhibited the least left ventricular hypertrophy, allograft replacement the greatest; however, valve preservation had the highest early risk of reoperation, allograft replacement the lowest. Patients receiving allografts had the highest risk of late reoperation (P

AB - Objective To evaluate long-term results of aortic root procedures combined with ascending aorta replacement for aneurysms, using 4 surgical strategies. Methods From January 1995 to January 2011, 957 patients underwent 1 of 4 aortic root procedures: valve preservation (remodeling or modified reimplantation, n = 261); composite biologic graft (n = 297); composite mechanical graft (n = 156); or allograft root (n = 243). Results Seven deaths occurred (0.73%), none after valve-preserving procedures, and 13 strokes (1.4%). Composite grafts exhibited higher gradients than allografts or valve preservation, but the latter 2 exhibited more aortic regurgitation (2.7% biologic and 0% mechanical composite grafts vs 24% valve-preserving and 19% allografts at 10 years). Within 2 to 5 years, valve preservation exhibited the least left ventricular hypertrophy, allograft replacement the greatest; however, valve preservation had the highest early risk of reoperation, allograft replacement the lowest. Patients receiving allografts had the highest risk of late reoperation (P

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Long-term survival, valve durability, and reoperation for 4 aortic root procedures combined with ascending aorta replacement

Abstract

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