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Published in: Journal of Cardiothoracic Surgery 1/2021

Open Access 01-12-2021 | Heart Surgery | Research article

Clinical analysis of redo aortic root replacement after cardiac surgery: a retrospective study

Authors: Jianying Deng, Qianjin Zhong

Published in: Journal of Cardiothoracic Surgery | Issue 1/2021

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Abstract

Objectives

To explore the etiology, previous cardiac procedure methods and outcomes of redo aortic root replacement after cardiac surgery.

Methods

A retrospective analysis of 41 patients who underwent aortic root replacement surgery in our hospital from February 2010 to February 2020 who underwent at least one cardiac surgery in the past, including 27 males and 14 females, with an average age of 49.5 ± 10.2 years old. Indications for reoperation include: aortic sinus dilation and ascending aortic aneurysm in 20 cases (48.8%), recurrent aortic dissection in 7 cases (17.1%), pseudoaneurysm of aortic root in 4 cases (9.8%), prosthetic valve endocarditis in 5 cases (12.2%) and paravalvular leakage in 5 cases (12.2%). According to whether the previous procedure involved aortic root surgery, they were divided into 2 groups, namely aortic root surgery-involved (ARS) group and non-aortic root surgery-involved (NRS) group. After the patients were discharged from hospitals, follow-ups were carried out through outpatient clinic or telephone for 5 years. Kaplan-Meier was used for survival analysis.

Results

All patients underwent Bentall procedure with a median sternum incision. Six patients (14.6%) died during the postoperative hospitalization and 3 patients (8.6%) died during the follow-up. The 1-year, 3-year, and 5-year survival in ARS group were 92.6, 92.6, and 92.6%, respectively; the 1-year, 3-year, and 5-year survival in NRS group were 100, 85.7, and 85.7%, respectively. There was no statistical difference between the two groups in the cause of redo aortic root replacement, procedure time, postoperative complications, postoperative hospital stay, hospital mortality, and 5-year cumulative survival (p > 0.05).

Conclusions

Redo aortic root replacement is difficult and high risk. Bentall procedure is still a reliable surgical option for redo aortic root replacement, with good short- and mid-term results. The prognosis of redo aortic root replacement is not necessarily related to the etiology of patient’s surgery and the methods of previous cardiac procedure.
Literature
6.
go back to reference Puehler T, Freitag-Wolf S, Friedrich C, Salem M, Renner J, Cremer J, et al. Outcomes of patients after implantation of the pericardial all-biological valve no-react aortic conduit (BioIntegral) for root replacement in complex surgical procedures. Thorac Cardiovasc Surg. 2020;68(4):301–8. https://doi.org/10.1055/s-0039-1683425.CrossRefPubMed Puehler T, Freitag-Wolf S, Friedrich C, Salem M, Renner J, Cremer J, et al. Outcomes of patients after implantation of the pericardial all-biological valve no-react aortic conduit (BioIntegral) for root replacement in complex surgical procedures. Thorac Cardiovasc Surg. 2020;68(4):301–8. https://​doi.​org/​10.​1055/​s-0039-1683425.CrossRefPubMed
7.
go back to reference Shrestha M, Khaladj N, Baraki H, al Ahmad A, Koigeldiyev N, Pichlmaier M, et al. Aortic root reoperation: a technical challenge. J Heart Valve Dis. 2010;19(2):177–81.PubMed Shrestha M, Khaladj N, Baraki H, al Ahmad A, Koigeldiyev N, Pichlmaier M, et al. Aortic root reoperation: a technical challenge. J Heart Valve Dis. 2010;19(2):177–81.PubMed
12.
go back to reference Disha K, Rouman M, Secknus MA, et al. Are normal-sized ascending aortas at risk of late aortic events after aortic valve replacement for bicuspid aortic valve disease? Interact Cardiovasc Thorac Surg. 2016;22(4):465–71.CrossRef Disha K, Rouman M, Secknus MA, et al. Are normal-sized ascending aortas at risk of late aortic events after aortic valve replacement for bicuspid aortic valve disease? Interact Cardiovasc Thorac Surg. 2016;22(4):465–71.CrossRef
13.
go back to reference Pitt MP, Bonser RS. The natural history of thoracic aortic aneurysm disease: an overview. J Card Surg. 1997;12(2 Suppl):270–8.PubMed Pitt MP, Bonser RS. The natural history of thoracic aortic aneurysm disease: an overview. J Card Surg. 1997;12(2 Suppl):270–8.PubMed
14.
go back to reference Hiratzka LF, Bakris GL, Beckman JA, et al. 2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM guidelines for the diagnosis and management of patients with thoracic aortic disease: Executive summary. A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, and Society for Vascular Medicine. Catheter Cardiovasc Interv. 2010;76(2):E43–86.CrossRef Hiratzka LF, Bakris GL, Beckman JA, et al. 2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM guidelines for the diagnosis and management of patients with thoracic aortic disease: Executive summary. A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, and Society for Vascular Medicine. Catheter Cardiovasc Interv. 2010;76(2):E43–86.CrossRef
19.
go back to reference Chello C, Lusini M, Nenna A, Nappi F, Spadaccio C, Satriano UM, et al. Deep sternal wound infection (DSWI) and mediastinitis after cardiac surgery: current approaches and future trends in prevention and management. Surg Technol Int. 2020;36:212–6.PubMed Chello C, Lusini M, Nenna A, Nappi F, Spadaccio C, Satriano UM, et al. Deep sternal wound infection (DSWI) and mediastinitis after cardiac surgery: current approaches and future trends in prevention and management. Surg Technol Int. 2020;36:212–6.PubMed
Metadata
Title
Clinical analysis of redo aortic root replacement after cardiac surgery: a retrospective study
Authors
Jianying Deng
Qianjin Zhong
Publication date
01-12-2021
Publisher
BioMed Central
Published in
Journal of Cardiothoracic Surgery / Issue 1/2021
Electronic ISSN: 1749-8090
DOI
https://doi.org/10.1186/s13019-021-01587-8

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