Aortic Valve Preservation in Acute Type A Dissection: Mid-Term Results
Wlodzimierz Kuroczynski MD, Guido Dohmen MD, Ulrich Hake MD, Michael Hilker MD, Yeong-Hoon Choi MD, Susanne Anaraki MD, Susanne Mohr-Kahaly MD, Markus Heinemann MD, Hellmut Oelert MD

Results after surgery for acute type A dissection with preservation of the aortic valve were reviewed.The patient group included 57 hospital survivors operated on according to a surgical strategy of aortic valve resuspension and supracoronary ascending aortic graft implantation. Reinforcement of the aortic stumps with gelatin-resorcinol-formaldehyde glue was performed in all patients.During the follow up period, nine patients (16%) died without reoperation. Actuarial probability of freedom from reoperation for aortic valve failure in the complete series was estimated as 100% after both 30 days and 12 months. Postoperatively, one patient underwent reoperation 14 months for aortic regurgitation, and three patients for aortic regurgitation with sinus of Valsalva aneurysm between 48 and 88 months. The hospital mortality rate at reoperation was 50% (n = 2). Valve-sparing surgery is possible and can be recommended for the majority of patients with acute type A aortic dissection.