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  • Radical replacement of the aortic root in acute type A dissection: indications and outcome
  • Ergin MA; McCullough J; Galla JD; Lansman SL; Griepp RB
  • Eur J Cardiothorac Surg 1996[]; 10 (10): 840-4; discussion 845
  • OBJECTIVE: Failure of the repair at the proximal aorta is an important cause of morbidity and mortality following surgical treatment of acute type A dissection. This review was undertaken to determine the influence of total composite replacement of the ascending aorta and the root on the operative risk and long-term survival. METHODS: In a consecutive series of 73 patients with acute type A dissections between 1985 and 1994, 19 (26%) patients with radical root replacement (group I) were compared with 54 patients who had conventional valve-preserving root reconstruction (group II). RESULTS: Group I represented a higher operative risk with the presence of significant aortic regurgitation (13/19 68.4% vs 23/54 42.5% P < 0.05), aortic dilatation (19/19 100% vs 32/54 59.2% P < 0.00), and coronary dissection (13/19 68.4% vs 3/54 5.5% P < 0.000). In spite of this there was no difference in operative mortality (3/19 15.7% vs 7/54 12.9%, NS) or the occurrence of major postoperative complications: bleeding (3/19 15.7% vs 7/54 12.9%, NS), respiratory (5/19 26.3% vs 11/54 20.3%, NS), stroke (2/19 10.5% vs 3/54 5.5%, NS). Patients with radical root replacement had substantially better event-free survival at 5 years (87.5% +/- 11.7% vs 67.1% +/- 8.9%) and 9 years (87.5% +/- 21.9% vs 63.0% +/- 19.2%). CONCLUSIONS: This experience confirms that, in the treatment of acute type A dissection, an aggressive approach to aortic root pathology is indicated for specific indications, and can be carried out with good early and excellent long-term results.
  • |*Blood Vessel Prosthesis[MESH]
  • |*Heart Valve Prosthesis[MESH]
  • |Adult[MESH]
  • |Aged[MESH]
  • |Aged, 80 and over[MESH]
  • |Aneurysm, Dissecting/mortality/*surgery[MESH]
  • |Aortic Aneurysm, Thoracic/mortality/*surgery[MESH]
  • |Aortic Valve Insufficiency/mortality/surgery[MESH]
  • |Cause of Death[MESH]
  • |Female[MESH]
  • |Follow-Up Studies[MESH]
  • |Humans[MESH]
  • |Male[MESH]
  • |Middle Aged[MESH]
  • |Prosthesis Design[MESH]
  • |Risk[MESH]
  • |Survival Analysis[MESH]





  • *{{pmid8911836}}
    *<b>[http://www.kidney.de/mlpefetch.php?search=8911836 Radical replacement of the aortic root in acute type A dissection: indications and outcome ]</b> Eur J Cardiothorac Surg 1996; 10(10) ; 840-4; discussion 845 Ergin MA; McCullough J; Galla JD; Lansman SL; Griepp RB

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    Eur J Cardiothorac Surg

    840 10.10 1996