Comparison of Aortic Valve Sparing Operation Methods; Early and Midterm Results of a Single Center Experience

  • #AC/AOR 01-O-7
  • Adult Cardiac Surgery/Aortic. SESSION-1
  • Oral

Comparison of Aortic Valve Sparing Operation Methods; Early and Midterm Results of a Single Center Experience

Oğuz Uğur 1, Abdullah K. Tuygun 2, Begüm Kasapoğlu 2, Mutlu şenocak 2, Gözde Tekin 2

SBU konya state hospital, konya, Turkey; Siyami ersek cardiovascular surgery center, istanbul, Turkey;

Date, time and location: 2018.05.27 08:30, Congress Hall, 2F–B


Objectives: In our study we compared aortic valve sparing(AVS) operation techniques after aortic pathologies, have aortic root enlargement. We examined early-midterm results of remodelling and reimplantation techniques.

Methods: Between 2004-2012, 54 patients with aortic pathologies underwent AVS operations. 15(27.7%) patients were operated withremodelling technique and 39(72.2%) with reimplantation technique.

Remodelling and reimplantation tecniques compared using cross clamp, cardiopulmonary bypass(CPB) times, graft sizes, postoperative bleeding, extubation time, ICU and hospital length ofstay, arrhythmia, mortality and morbidity. Also valvular morphology and the effect of the operative technique in the progression of valvular insuffiency were evaluated for 6-36 months.

Results: 23(42,5%) patients were female and 31(57,7%) were male. Mean age was 51,5±13,2(range:16-78) years. 46(85,2%) patients had ascending aneurysm, 5(9,3%) of had acute and 3(5,6%) of had chronic type-A dissection. In 10(18,5%)
patients aortic valve morphology was bicuspid, 44(81,5%) was tricuspid. 4(26,7%) of bicuspid and 11(73.3%)with tricuspid valves had remodelling, 6(15.4%) of bicuspid, 33(%84,6) of tricuspid had reimplantation technique.

No relationships were found between family history and severe aortic insufficiency(p=0,19). There were no significancy between two techniques about cross clamp times(p= 0,424)s, CPB times(p= 0,54), graft sizes(≤30mm and ≥32mm, P=0,716), postoperative inotropic needs(p=0,147), bleeding(p=0,486), extubation time(p=0,820), ICU stay(p=0,4119), length ofhospital stay(p=0,268) and arytmias(P=0,193).

Two(15,4%) patients of remodelling and 6(16,2%) of reimplantation grouphad moderate-severe aortic insuffiency but no significancy between two techniques(P=0,944).

Three(5,5%) patients were operated in emergency and 1(1,8%) of them operated with reimplantation methods, died of cardiac failure. In the elective group, there were 2(13,3%) deaths from remodelling and 2(5,3%) from reimplantationgroup(p=0,316).

Conclusions: In emergency or elective aortic root pathologies even if or not aortic insufficiency exists,AVS surgery is important by its long term effectiveness and advantages.

Between remodeling and reimplantation technique no obvious differences found in feasibility, valve durability, postoperative complications and mortality.

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