Reinforced aortic root reconstruction for acute type A aortic dissection involving the aortic root.
OBJECTIVE
There are debates regarding the optimal approach for AAAD involving the aortic root. We described a modified reinforced aortic root reconstruction approach for treating AAAD involving the aortic root.


METHODS
A total of 161 patients with AAAD involving the aortic root were treated by our modified reinforced aortic root reconstruction approach from January 1998 to December 2008. Key features of our modified approach were placement of an autologous pericardial patch in the false lumen, lining of the sinotubular junction lumen with a polyester vascular ring, and wrapping of the vessel with Teflon strips. Outcome measures included post-operative mortality, survival, complications, and level of aortic regurgitation.


RESULTS
A total of 161 patients were included in the study (mean age: 43.3 1 15.5 years). The mean duration of follow-up was 5.1 1 2.96 years (2-12 years). A total of 10 (6.2%) and 11 (6.8%) patients died during hospitalization and during follow-up, respectively. Thirty-one (19.3%) patients experienced postoperative complications. The 1-, 3-, 5-, and 10-year survival rates were 99.3%, 98%, 93.8%, and 75.5%, respectively. There were no instances of recurrent aortic dissection, aortic aneurysm, or pseudoaneurysm during the entire study period. The severity of aortic regurgitation dramatically decreased immediately after surgery (from 28.6% to 0% grade 3-4) and thereafter slightly increased (from 0% to 7.2% at 5 years and 9.1% at 10 years).


CONCLUSIONS
This modified reinforced aortic root reconstruction was feasible, safe and durable/effective, as indicated by its low mortality, low postoperative complications and high survival rate.
Shanghai Hospital, Second Military Medical University, Shanghai, People's Republic of China.
Qing-qi
QQ
Han
Zhi-gang
ZG
Song
Liang-jian
LJ
Zou
Lin
L
Han
Fang-lin
FL
Lu
Xi-long
XL
Lang
Zhi-yun
ZY
Xu
D000293:Adolescent; D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000401:mortality / Q000601:surgery*; D001011:Aorta / Q000601:surgery*; D001014:Aortic Aneurysm / Q000401:mortality / Q000601:surgery*; D001021:Aortic Valve / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011184:Postoperative Period; D015203:Reproducibility of Results; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods*; D055815:Young Adult