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Ann Thorac Surg. 2000 Sep;70(3):851-5.

Composite graft replacement of the aortic root after previous cardiac surgery: a 20-year experience.

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1
Cardiothoracic Surgical Unit, Royal Prince Alfred Hospital, Sydney, Australia.

Abstract

BACKGROUND:

An aging population and prolonged survival of patients after cardiac operations has meant that composite aortic root replacement after previous cardiac operation is being performed with increasing frequency.

METHODS:

From January 1979 to July 1999, 32 patients underwent "reoperative" composite replacement of the aortic root at our institution. Previous operations were 16 aortic valve replacement, 9 coronary artery bypass grafting, 5 repair aortic dissection, and 7 others. Indications for operation included ascending aortic aneurysm in 16 patients, ascending aortic dissections in 10 patients, and other in 6 patients.

RESULTS:

The unit elective mortality was 3 of 26 (11.5%). One surgeon's elective mortality was 1 of 22 (4.6%). The unit emergent mortality was 6 of 6 (100%). There has been one late death. Morbidity was low.

CONCLUSIONS:

Reoperative aortic root replacement is a technically demanding procedure, but expertise in the area achieves low elective mortality. Consideration should be given to aortic root replacement at the initial procedure. Close follow-up of postcardiac operation patients is necessary to proceed with elective aortic root replacement if indicated. Emergent presentation in the reoperative setting has a very poor prognosis.

PMID:
11016322
[Indexed for MEDLINE]

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