Charalampos Katselis1, George Samanidis1,5, Anastasia Papasotiriou1, Ioannis Kriaras2, Theofani Antoniou3, Mazen Khoury4, Alkiviadis Michalis4, Konstantinos Perreas11First Department of Adult Cardiac Surgery, Onassis Cardiac Surgery Center, Athens, Greece
2Cardiac Surgery Intensive Care Unit, Onassis Cardiac Surgery Center, Athens, Greece
3Department of Anesthesiology, Onassis Cardiac Surgery Center, Athens, Greece
4Second Department of Adult Cardiac Surgery, Onassis Cardiac Surgery Center, Athens, Greece
5Electronic correspondence: email@example.com
Background and aim of the study: Composite graft replacement of the aortic root is the treatment of choice for an array of aortic root pathologies, such as annuloaortic ectasia, Marfan syndrome and acute or chronic aortic dissection type A. In this retrospective study of the authors’ aortic surgery database, an exploration was made of factors related to early and long-term morbidity and mortality of patients who underwent this procedure.
Methods: Between 2000 and 2009, a total of 200 consecutive patients (male:female ratio 4:1; mean age 56.2 ± 11.66 years) underwent the modified Bentall operation at the authors’ institution, with a composite graft (mechanical valve) being used to correct aortic root pathology. All preoperative, perioperative and postoperative data, as well as long-term follow up data, were retrieved from the authors’ aortic surgery database.
Results: Preoperative characteristics of the patients included elective and emergency operations (83.1% and
15.9%, respectively). Intraoperative and 30-day mortalities were 2% and 3.5%, respectively, while the rate of postoperative cerebrovascular events was 1.5%. Long-term survival at a mean follow up of 110 months for the elective and emergency groups was 88.6% and 71.9%, respectively (p = 0.007). Moreover, during the same period new cerebrovascular events were observed in 5.8% of cases. Predictive factors for late survival were type of surgery (elective versus emergency; p = 0.023), conduit size (≤23 mm versus >23 mm; p = 0.053) , age >65 years (p = 0.001), intensive care unit stay (days; p <0.001) and postoperative creatinine level (p = 0.002). Survival rates at one, three, five and 10 years postoperatively were 93.5%, 92.5%, 91.5% and 85.9%, respectively.
Conclusion: Patients who underwent the modified Bentall operation presented with minimal major adverse effects and demonstrated a good long-term survival.
The Journal of Heart Valve Disease 2017;26:639-645
|Long-Term Results after Modified Bentall Operation in 200 Patients|
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