Volume 36, Issue 5 pp. 1786-1792
Special Section: Trend & Controversies in Type A Aortic Surgery in 21st Century

Prosthetic valve sparing aortic root replacement—A persuasive option in well-functioning aortic valve prosthesis

A. Mohammed Idhrees MCh, FAIS

Corresponding Author

A. Mohammed Idhrees MCh, FAIS

Institute of Cardiac and Aortic Disorders (ICAD), SRM Institutes for Medical Science (SIMS Hospital), Chennai, India

Correspondence A. Mohammed Idhrees MCh, FAIS, Cardio Thoracic and Vascular Surgeon, Institute of Cardiac and Aortic Disorders, SRM Institutes for Medical Science (SIMS Hospitals), Chennai, Tamil Nadu 600 026, India.

Email: [email protected]

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Bashi V. Velayudhan MCh

Bashi V. Velayudhan MCh

Institute of Cardiac and Aortic Disorders (ICAD), SRM Institutes for Medical Science (SIMS Hospital), Chennai, India

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Aju Jacob MD

Aju Jacob MD

Institute of Cardiac and Aortic Disorders (ICAD), SRM Institutes for Medical Science (SIMS Hospital), Chennai, India

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First published: 02 February 2021
Citations: 1

Abstract

Objectives

Only limited data is available on prosthetic valve sparing aortic root replacement after aortic valve replacement. The aim of the present study was to assess the short- and midterm outcomes of the patients who underwent such procedures.

Methods

From June 2004 to March 2018, 21 patients underwent this procedure. The mean age was 51.2 ± 10.2 years with a male predominance (85.7%). The mean time interval from aortic valve replacement to the present surgery was 10.62 years.

Results

One patient died in immediate postoperative period who was taken up for emergency surgery—acute type A aortic dissection. Kaplan–Meier estimates of 1, 3, and 5 year survival were 95.2% ± 0.04%, 85.7% ± 0.07% and 85.7% ± 0.07%, respectively. No cardiac or aortic reinterventions were performed during follow up with a 100% freedom from reoperation at 5 years. Fifteen patients (71.43%) had aortopathy and had borderline pathology at the time of first surgery, with all of them having a tear either in the aortic sinuses or pervious aortotomy site.

Conclusion

The favorable short and midterm results suggests that prosthetic valve sparing aortic root replacement is a valid option when possible. Utmost care has to be taken at the primary surgery especially in patients with aortopathy, trying to avoid the need for a second surgery.

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