Aortic root replacements in reoperations.
We evaluated 4 patients who had undergone previous cardiac surgery underwent reoperation involving aortic root replacement. Subjects were a 55-year-old man who had undergone separate valve graft replacement for a dissecting aneurysm (DeBakey type I) 3.25 years earlier; a 51-year-old woman who had undergone separate valve graft replacement for a dissecting aneurysm (DeBakey type I) 6 years earlier; a 66-year-old woman who had undergone aortic valve replacement and single coronary artery bypass grafting for severe aortic regurgitation, angina pectoris, and aortitis syndrome 11 years earlier; a 47-year-old man who had undergone mitral valve replacement and 3-coronary artery bypass grafting for severe mitral regurgitation and angina pectoris 4 years earlier. Development of a surgical technique, coupled with myocardial protection, and pharmacological treatment at reoperation yielded excellent early surgical results. To reduce the incidence of reoperation and ensure satisfactory long-term results, we recommend radical management for the individual case be selected at initial operation and entire resections be conducted for aneurysmal degeneration or dissected segments.
Morishita
Atsushi
A
Department of Cardiovascular Surgery, Fukuyama Cardiovascular Hospital, 1-26 Sumiyoshi-cho, Fukuyama, Hiroshima 720-0809, Japan.
Shimakura
Tadayuki
T
Miyagishima
Masayuki
M
Kawamoto
Jun
J
Umehara
Nobuhiro
N
D000368:Aged; D000784:Aortic Dissection / Q000601:surgery; D001011:Aorta / Q000601:surgery*; D001014:Aortic Aneurysm / Q000601:surgery; D001021:Aortic Valve / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation; D006348:Cardiac Surgical Procedures / Q000379:methods; D005260:Female; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D016896:Treatment Outcome