Profesionales médicos

Overview

Juan A. Crestanello, M.D., is a cardiovascular surgeon and department chair of Cardiovascular Surgery at Mayo Clinic in Rochester, Minnesota. Dr. Crestanello, who specializes in surgery for valvular heart disease, discusses outcomes and risk factors of late failure of valve-sparing aortic root replacement.

JUAN CRESTANELLO: Imagine you're seeing a young patient with an aortic root aneurysm, tricuspid aortic valve, and connective tissue disorder. The patient is interested in knowing the outcomes and late results of valve-sparing aortic root surgery. This article will help to answer those questions. I am Dr. Juan Crestanello. Welcome to the Cardiovascular Surgery Series. I will discuss today the outcomes and risk factors of late failure of valve-sparing aortic root replacement.

We reviewed 342 patients who had valve-sparing root replacement at our clinic. Forty percent of the patients had a connective tissue disorder. The re-implantation technique was used in 90% of the patients. The operating mortality was 1%. Ninety-five percent of the patients had mild or less aortic regurgitation at the time of discharge. Severely dilated aortic annulus was a predictor of early failure.

Long-term survival was 84% at 10 years and 69% at 15 years. The probability of having severe aortic regurgitation at 10 years was just 8%. The rate of reoperation for aortic valve replacement was 17% at 15 years. Reoperations were for aortic regurgitation in 82% of the patients, and for aortic stenosis in 13%.

We conclude that valve-sparing aortic root replacement is an excellent option to treat patients with root aneurysms. It is associated with very low operative mortality, excellent long-term survival, and low rates of aortic valve replacement. Thank you for listening to the Cardiovascular Surgery Series.