Concomitant replacement of the aortic root and aortic arch with or without secondary thoracoabdominal aorta replacement.
OBJECTIVE
Extensive aortic replacement, such as concomitant aortic root and arch replacement, thoracoabdominal aortic repair, and complete thoracic aorta replacement, remains controversial. We studied surgical morbidity and mortality in patients undergoing concomitant aortic root and arch replacement, and those undergoing secondary replacement of the thoracoabdominal aorta after this preceding procedure.


METHODS
Between January, 1987 and March 1999, 21 patients (mean age: 52 years) underwent concomitant aortic root and arch replacement involving 3 surgical procedures--aortic root replacement with composite graft and arch (n = 12), aortic root replacement with valve sparing and arch (n = 4), or aortic root replacement with composite graft and arch and elephant trunk (n = 5).


RESULTS
Overall hospital mortality was 4.8%. Six patients (mean age: 42 years) underwent secondary thoracoabdominal aorta replacement after the concomitant root and arch procedure. The mean time until secondary surgery was 9.5 months. There was 1 hospital death.


CONCLUSIONS
Concomitant replacement of the aortic root and arch, or secondary replacement of the thoracoabdominal aorta after concomitant root and arch replacement can be conducted with low surgical morbidity and mortality.
Department of Cardiovascular Surgery, Graduate School of Medicine, Tohoku University, 1-1 Seiryo-cho, Aoba-ku, Sendai, 980-8574, Japan.
K
K
Tabayashi
H
H
Yokoyama
A
A
Iguchi
S
S
Watanabe
T
T
Fukujyu
Y
Y
Tsuru
K
K
Niibori
H
H
Akimoto
M
M
Tofukuji
D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000784:Aortic Dissection / Q000601:surgery*; D001012:Aorta, Abdominal / Q000601:surgery; D001013:Aorta, Thoracic / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D001021:Aortic Valve / Q000601:surgery; D001807:Blood Vessel Prosthesis; D005260:Female; D006324:Heart Arrest, Induced / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D016896:Treatment Outcome