title: Long-term results of aortic root repair using the reimplantation technique.
abstract: OBJECTIVE
  Aortic valve sparing is frequently performed to treat patients with aortic root aneurysm, but there is an inadequate amount of information regarding its long-term durability. This study examines the long-term results of reimplantation of the aortic valve in patients with aortic root aneurysms.
  
  
  METHODS
  From August 1989 to December 2010, 296 consecutive patients had reimplantation of the aortic valve into a tubular Dacron graft. Their mean age was 45 years (range, 11-79 years), and 78% were men. Of the patients, 36% had Marfan syndrome and 11% had bicuspid aortic valve. Patients were followed prospectively with periodic images of the aortic root and remaining aorta. The mean follow-up was 6.9 ± 4.5 years. There were 21 patients at risk at 15 years.
  
  
  RESULTS
  There were 4 operative and 18 late deaths. The survival at 5, 10, and 15 years was 95.1% ± 3.5%, 93.1% ± 4.4%, and 76.5% ± 18%, respectively. Only 3 patients required reoperation on the aortic valve; all 3 patients had the Bentall procedure. Freedom from reoperation at 5, 10, and 15 years was 99.7% ± 2.0%, 97.8% ± 5.3%, and 97.8% ± 5.3%, respectively. During follow-up, moderate aortic insufficiency developed in 9 patients, and severe aortic insufficiency developed in 2 patients. Freedom from moderate or severe aortic insufficiency at 5, 10, and 15 years was 98.3% ± 3.5%, 92.9% ± 6.5%, and 89.4% ± 12%, respectively.
  
  
  CONCLUSIONS
  The function of the aortic valve implanted inside a tubular Dacron graft remains normal at 15 years in most patients after this type of aortic valve-sparing operation.
authors.affiliation: Division of Cardiovascular Surgery of Peter Munk Cardiac Centre at Toronto General Hospital and the University of Toronto, Toronto, Ontario, Canada. tirone.david@uhn.ca
authors.forename: Tirone E
authors.initials: TE
authors.lastname: David
authors.forename: Susan
authors.initials: S
authors.lastname: Armstrong
authors.forename: Cedric
authors.initials: C
authors.lastname: Manlhiot
authors.forename: Brian W
authors.initials: BW
authors.lastname: McCrindle
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Feindel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001014:Aortic Aneurysm / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D001021:Aortic Valve / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000209:etiology / Q000601:surgery; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D002648:Child; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009864:Ontario; D011093:Polyethylene Terephthalates; D016016:Proportional Hazards Models; D011474:Prosthesis Design; D012086:Reoperation; D012092:Replantation / Q000009:adverse effects / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D011093:Polyethylene Terephthalates