Long-term outcomes of survival and freedom from reoperation on the aortic root or valve after surgery for acute ascending aorta dissection

Zhengjun Wang, Kevin L. Greason, Alberto Pochettino, Hartzell V Schaff, Rakesh M. Suri, John M. Stulak, Joseph A. Dearani

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Conclusions Operative morbidity and mortality rates are significant after repair of acute ascending aorta dissection. Aortic root surgery can be performed without an apparent increase in the prevalence of operative morbidity or mortality; however, patients remain at risk of subsequent aortic root or valve surgery.

Objective Limited long-term outcome data are available on survival and the need for aortic root or valve reoperation after surgery for acute ascending aorta dissection. We report our 42-year experience.

Methods We reviewed the records of 269 patients who had undergone surgery for acute ascending aorta dissection from July 1969 to June 2011. The mean age at surgery was 62.1 ± 15.2 years, and 181 were men (67.3%). The distal operation was limited to hemiarch replacement. The proximal aortic operation groups included a composite valve conduit in 66 patients (24.5%), aortic root repair in 112 (41.6%), and isolated supracoronary ascending aorta replacement in 91 (33.8%).

Results Operative morbidity occurred in 224 patients (83.3%) and mortality in 44 (16.4%), with similar rates among the groups (P =.894 and P =.466, respectively). The mean follow-up was 9.7 ± 7.5 years. The Kaplan-Meier survival estimate at 10 and 20 years was 65.5% ± 3.6% and 28.7% ± 4.3%, respectively, and was similar among the groups (P =.227). Reoperation on the aortic root or valve occurred in 20 patients (8.9%) at a median of 6.8 years (range, 0.2-20.3). The freedom from reoperation rate at 10 and 20 years was 91.5% ± 2.3% and 79.3% ± 6.1%, respectively, with no difference among the groups (P =.605).

Original languageEnglish (US)
Pages (from-to)2117-2122
Number of pages6
JournalJournal of Thoracic and Cardiovascular Surgery
Volume148
Issue number5
DOIs
StatePublished - Nov 1 2014

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Reoperation
Aorta
Dissection
Survival
Morbidity
Mortality
Kaplan-Meier Estimate

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine
  • Medicine(all)

Cite this

Long-term outcomes of survival and freedom from reoperation on the aortic root or valve after surgery for acute ascending aorta dissection. / Wang, Zhengjun; Greason, Kevin L.; Pochettino, Alberto; Schaff, Hartzell V; Suri, Rakesh M.; Stulak, John M.; Dearani, Joseph A.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 148, No. 5, 01.11.2014, p. 2117-2122.

Research output: Contribution to journalArticle

Wang, Zhengjun ; Greason, Kevin L. ; Pochettino, Alberto ; Schaff, Hartzell V ; Suri, Rakesh M. ; Stulak, John M. ; Dearani, Joseph A. / Long-term outcomes of survival and freedom from reoperation on the aortic root or valve after surgery for acute ascending aorta dissection. In: Journal of Thoracic and Cardiovascular Surgery. 2014 ; Vol. 148, No. 5. pp. 2117-2122.
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T1 - Long-term outcomes of survival and freedom from reoperation on the aortic root or valve after surgery for acute ascending aorta dissection

AU - Wang, Zhengjun

AU - Greason, Kevin L.

AU - Pochettino, Alberto

AU - Schaff, Hartzell V

AU - Suri, Rakesh M.

AU - Stulak, John M.

AU - Dearani, Joseph A.

PY - 2014/11/1

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N2 - Conclusions Operative morbidity and mortality rates are significant after repair of acute ascending aorta dissection. Aortic root surgery can be performed without an apparent increase in the prevalence of operative morbidity or mortality; however, patients remain at risk of subsequent aortic root or valve surgery.Objective Limited long-term outcome data are available on survival and the need for aortic root or valve reoperation after surgery for acute ascending aorta dissection. We report our 42-year experience.Methods We reviewed the records of 269 patients who had undergone surgery for acute ascending aorta dissection from July 1969 to June 2011. The mean age at surgery was 62.1 ± 15.2 years, and 181 were men (67.3%). The distal operation was limited to hemiarch replacement. The proximal aortic operation groups included a composite valve conduit in 66 patients (24.5%), aortic root repair in 112 (41.6%), and isolated supracoronary ascending aorta replacement in 91 (33.8%).Results Operative morbidity occurred in 224 patients (83.3%) and mortality in 44 (16.4%), with similar rates among the groups (P =.894 and P =.466, respectively). The mean follow-up was 9.7 ± 7.5 years. The Kaplan-Meier survival estimate at 10 and 20 years was 65.5% ± 3.6% and 28.7% ± 4.3%, respectively, and was similar among the groups (P =.227). Reoperation on the aortic root or valve occurred in 20 patients (8.9%) at a median of 6.8 years (range, 0.2-20.3). The freedom from reoperation rate at 10 and 20 years was 91.5% ± 2.3% and 79.3% ± 6.1%, respectively, with no difference among the groups (P =.605).

AB - Conclusions Operative morbidity and mortality rates are significant after repair of acute ascending aorta dissection. Aortic root surgery can be performed without an apparent increase in the prevalence of operative morbidity or mortality; however, patients remain at risk of subsequent aortic root or valve surgery.Objective Limited long-term outcome data are available on survival and the need for aortic root or valve reoperation after surgery for acute ascending aorta dissection. We report our 42-year experience.Methods We reviewed the records of 269 patients who had undergone surgery for acute ascending aorta dissection from July 1969 to June 2011. The mean age at surgery was 62.1 ± 15.2 years, and 181 were men (67.3%). The distal operation was limited to hemiarch replacement. The proximal aortic operation groups included a composite valve conduit in 66 patients (24.5%), aortic root repair in 112 (41.6%), and isolated supracoronary ascending aorta replacement in 91 (33.8%).Results Operative morbidity occurred in 224 patients (83.3%) and mortality in 44 (16.4%), with similar rates among the groups (P =.894 and P =.466, respectively). The mean follow-up was 9.7 ± 7.5 years. The Kaplan-Meier survival estimate at 10 and 20 years was 65.5% ± 3.6% and 28.7% ± 4.3%, respectively, and was similar among the groups (P =.227). Reoperation on the aortic root or valve occurred in 20 patients (8.9%) at a median of 6.8 years (range, 0.2-20.3). The freedom from reoperation rate at 10 and 20 years was 91.5% ± 2.3% and 79.3% ± 6.1%, respectively, with no difference among the groups (P =.605).

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