Clinical analysis of redo aortic root replacement after cardiac surgery
- VernacularTitle:心脏术后再次行主动脉根部置换的临床分析
- Author:
Jie LU
1
;
Qing XUE
1
;
Yangfeng TANG
1
;
Zhigang SONG
1
;
Hao TANG
1
;
Fanglin LU
1
;
Lin HAN
1
;
Zhiyun XU
1
Author Information
1. Department of Cardiovascular Surgery, Changhai Hospital, Naval Medical University, Shanghai, 200433, P.R.China
- Publication Type:Journal Article
- Keywords:
Aortic root replacement;
cardiac reoperation;
aortic diseases;
surgery
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2021;28(01):99-103
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the etiologies, operation techniques and outcomes of redo aortic root replacement after cardiac surgery. Methods Between December 2013 and December 2019, 30 patients who had at least one previous cardiac operation received aortic root replacement in our hospital, including 20 males and 10 females with an average age of 50.4±12.7 years. The mean time interval between this operation and the previous one was 8.0±8.5 years. The principal indication for surgery was aortic sinus dilatation and ascending aortic aneurysm in 14 patients (47%), acute aortic dissection in 5 patients (17%), pseudoaneurysm in 3 patients (10%), prosthetic valve endocarditis in 4 patients (13%), prosthetic leakage in 4 patients (13%). Bentall procedure was used in all 30 patients, with concomitant mitral valve plasticity or replacement in 5 patients, tricuspid valve plasticity in 6 patients, coronary artery bypass grafting in 3 patients, and total aortic arch replacement and elephant trunk procedure in 2 patients. Results The mean cardiopulmonary bypass time was 96-296 (161.3±43.0) min, and the mean aortic occlusion time was 48-117 (85.7±20.4) min. There were 5 in-hospital deaths with an overall in-hospital mortality of 17%. The causes of deaths were low cardiac output syndrome in 2 patients and septic shock in 3 patients. The follow-up time was 3-75 (33.5±21.1) months. Three patients died during the follow-up, 1 patient died of septic shock and 2 died of cerebral hemorrhage. Conclusion Redo aortic root replacement is difficult to deal with, and the risk is high. Preoperative evaluation is required, appropriate surgical approach, adequate myocardial protection, and a complete surgical plan are essential to ensure the success of the operation.
