Does Type Of Aortic Root Repair In Acute Type A Dissection Matter? A Comparison Between Valve Sparing Procedures And The “Gold Standard”
Thorsten Hanke1, Ulrich Stierle1, Efstratios I. Charitos1, Martin Misfeld2, Hans-H. Sievers1.
1University of L�beck, L�beck, Germany, 2University of Leipzig, Heart Centre, Leipzig, Germany.
Objective:
Utilizing complex surgical aortic root procedures in acute Type A aortic dissection is still a matter of debate. We reviewed the midterm results in our institution.
Methods:
Aortic valve sparing procedures as well as the “gold standard” aortic valve/ascending aorta conduits (Bentall) operations for type A aortic dissection performed since 1993 were identified and follow-up information was gathered by contacting the patient and/or his/her physician. Results were compared using Kaplan-Meier curves. Patients with Marfan´s syndrome are not included in this analysis.
Results:
86 operations were performed, 27 valve/ascending aorta conduits (Bentall; 31%; group B), 33 valve reimplantation procedures (David; 38%; group D), and 26 valve remodelling procedures (Yacoub; 30%, group Y).
Probability of survival and freedom from aortic reoperation at 10 years was 57.9% in group B, 52% in group D and 44 % in group Y.
Overall survival and freedom of reoperation did not differ according to the type of surgery performed, p=0,755 (Figure 1).
Conclusions:
When tailored to the specific pathology, aortic valve sparing procedures in comparison to the gold standard Bentall procedure for treatment of the aortic root in type A aortic dissections yield satisfying midterm results regarding survival and freedom of reoperation.
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