title: [Simplified aortic root replacement in the era of complex operation].
abstract: OBJECTIVE
  The purpose of the present study is to assess the clinical results of aortic root replacement using the Carbo-Seal composite graft( CS) compared with the other type of homemade composite grafts. Fifty-nine patients who underwent aortic root replacement between January 1998 to December 2010 were retrospectively analyzed. Twenty-six received homemade composite graft( group 1;1998 ~ 2005) and 33 received CS( group 2;2005 ~ 2010).
  
  
  RESULTS
  The duration of operation was longer in group 1:469.2±143.5 min versus 380.3±153.9 min (p=0.03). Although there was no statistically significant difference, group 2 had a higher complex operation rate compared with group1(23.1% versus 45.5%, p=0.07). Overall hospital mortality was 11.5% in group1 versus 3.0% in group2. Prevalence of major complication was significantly lower in group 2 (46.2% versus 18.2%, p=0.02).Requirement of intraoperative blood transfusion (group 1;1,130.8±854.7 ml versus group 2;598.2±836.4 ml) and amount of blood loss in the 1st 12 hours post operation (group 1;628.3±474.6 ml versus group 2;447.8±253.2 ml) were significantly lower in group 2. By univariate analysis, duration of operation, duration of cardio-pulmonary bypass (CPB), blood transfusion, acute dissection were independent risk factors and CS use was negative risk factor for major events. Aortic root replacement with use of CS can be performed with a relatively low early mortality and morbidity. Because a complicated operation is increasing in recent years, use of CS graft may simplify a Bentall operation.
authors.affiliation: Department of Cardiovascular Surgery, Tachikawa General Hospital, Nagaoka, Japan.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Sugimoto
authors.forename: Kazuo
authors.initials: K
authors.lastname: Yamamoto
authors.forename: Yuki
authors.initials: Y
authors.lastname: Okamoto
authors.forename: Takashi
authors.initials: T
authors.lastname: Wakabayashi
authors.forename: Kaori
authors.initials: K
authors.lastname: Kato
authors.forename: Shinya
authors.initials: S
authors.lastname: Mimura
authors.forename: Shinpei
authors.initials: S
authors.lastname: Yoshii
mesh_terms: D001011:Aorta / Q000601:surgery*; D016063:Blood Loss, Surgical; D001803:Blood Transfusion; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods* / Q000401:mortality; D002315:Cardiopulmonary Bypass; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D012189:Retrospective Studies