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Rethinking the Paradigm: Modern Approach to Proximal Aortic Reconstruction Demonstrates Excellent Outcomes
- Source :
- The heart surgery forum. 20(3)
- Publication Year :
- 2017
-
Abstract
- Background: Techniques for aortic surgery continue to evolve. A real-world snapshot of patients undergoing elective surgery for aneurysm in the modern era is helpful to assist in deciding the appropriate timing for intervention. We herein describe our experience with 100 consecutive patients who underwent primary elective surgery for aneurysm of the proximal thoracic aorta over a two-year period at a single institution. Methods: The majority of our patients were male, mean age 61.19 ± 13.33 years. Two patients had Marfan syndrome. Twenty-eight patients had bicuspid aortic valve. Thirty-four patients underwent aortic root replacement utilizing a composite valve/graft conduit; 23 had valve-sparing root replacements. The ascending aorta was replaced in 89 patients; 80 (89.9%) of these included a period of circulatory arrest at moderate hypothermia utilizing unilateral selective antegrade cerebral perfusion. Results: Thirty-day mortality was zero. Perioperative stroke occurred in 2 patients, both of whom completely recovered prior to discharge. No patients required re-exploration for bleeding. One patient developed a sternal wound infection. Fifteen patients required readmission to hospital within thirty days of discharge. Conclusion: Elective surgery for aneurysm of the proximal aorta is safe, reproducible, and is associated with outcomes that are superior to those seen in an acute aortic syndrome. It may be appropriate to offer surgery to younger patients with proximal aortic aneurysms at smaller diameters, even if their aortic dimensions do not yet meet traditional guidelines for surgical intervention.
- Subjects :
- Male
medicine.medical_specialty
New York
Aorta, Thoracic
030204 cardiovascular system & hematology
03 medical and health sciences
Aortic aneurysm
0302 clinical medicine
Aneurysm
Bicuspid aortic valve
Postoperative Complications
medicine.artery
Ascending aorta
medicine
Thoracic aorta
Humans
Elective surgery
Retrospective Studies
Acute aortic syndrome
Aorta
Aortic Aneurysm, Thoracic
business.industry
Middle Aged
Plastic Surgery Procedures
medicine.disease
Surgery
Survival Rate
030228 respiratory system
Elective Surgical Procedures
Anesthesia
cardiovascular system
Female
Morbidity
Cardiology and Cardiovascular Medicine
business
Vascular Surgical Procedures
Follow-Up Studies
Subjects
Details
- ISSN :
- 15226662
- Volume :
- 20
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- The heart surgery forum
- Accession number :
- edsair.doi.dedup.....039ea32d1969949eaaaf30f12434ef0c