| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
The Journal of Thoracic and Cardiovascular Surgery, Vol 102, 62-73, Copyright © 1991 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
JI Fann, DD Glower, DC Miller, KL Yun, JS Rankin, WD White, RL Smith, WG Wolfe and NE Shumway
Two hundred fifty-two patients underwent operation for type A aortic
dissection at Stanford University Medical Center from 1963 to 1987 and Duke
University Medical Center from 1975 to 1988. Sixty-seven percent had an
acute type A dissection and 33% had a chronic type A dissection. In
addition to repair or replacement of the ascending aorta, 121 patients
(48%) required an aortic valve procedure. Valve resuspension was performed
in 46 (39 acute type A and 7 chronic type A), with an operative mortality
rate of 13% +/- 5% (+/- 70% confidence limits), and aortic valve
replacement in 75 (36 acute type A and 39 chronic type A), with an
operative mortality rate of 20% +/- 5% (p = not significant versus
resuspension). The operative mortality rate for patients requiring only
repair or replacement of the ascending aorta was 32% +/- 4%. Indications
for valve replacement included coexistent (nonacute) aortic valve disease,
Marfan's syndrome, annuloaortic ectasia, and cases in which successful
resuspension could not be accomplished. The overall actuarial survival rate
for all patients was 59% +/- 3% (+/- 1 standard error of the mean), 40% +/-
4%, and 25% +/- 5% at 5, 10, and 15 years, respectively. Survival rates at
these same times for patients with valve resuspension were 67% +/- 8%, 52%
+/- 10%, and 26% +/- 19%, respectively; for patients who required aortic
valve replacement, these survival rates were 70% +/- 5%, 39% +/- 8%, and
21% +/- 11%; finally, patients who received only an ascending aortic
procedure had survival probabilities of 51% +/- 5%, 37% +/- 6%, and 23% +/-
6% (p = not significant versus resuspension versus aortic valve
replacement). Multivariate analysis showed advanced age (p less than
0.001), previous cardiac or aortic operation (p less than 0.001), more
preoperative dissection complications (p = 0.002), and earlier operative
date (p = 0.038) to be the only significant, independent factors that
increased the likelihood of early or late death. The type of aortic valve
procedure (resuspension versus aortic valve replacement versus none) was
not a significant predictor of mortality. Two of 46 patients with valve
resuspension required late aortic valve replacement (freedom from aortic
valve replacement: 100% and 80% +/- 13% at 5 and 10 years, respectively),
as did 4 of 75 patients with initial aortic valve replacement (freedom from
repeat aortic valve replacement: 98% +/- 2% and 73% +/- 13%,
respectively).(ABSTRACT TRUNCATED AT 400 WORDS)
ARTICLES
Preservation of aortic valve in type A aortic dissection complicated by aortic regurgitation
Department of Cardiovascular Surgery, Stanford University School of Medicine, CA 94305-5247.
This article has been cited by other articles:
|
|
 |
|
  F. Farhat, M. Durand, L. Boussel, I. Sanchez, J. Villard, and O. Jegaden Should a reimplantation valve sparing procedure be done systematically in type A aortic dissection? Eur. J. Cardiothorac. Surg., January 1, 2007; 31(1): 36 - 41. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. E. S.H. Tan, W. J. Morshuis, K. M.E. Dossche, J. C. Kelder, F. G.J. Waanders, and M. A.A.M. Schepens Long-Term Results After 27 Years of Surgical Treatment of Acute Type A Aortic Dissection Ann. Thorac. Surg., August 1, 2005; 80(2): 523 - 529. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Chiappini, M. Schepens, E. Tan, A. D. Amore, W. Morshuis, K. Dossche, M. Bergonzini, N. Camurri, L. B. Reggiani, G. Marinelli, et al. Early and late outcomes of acute type A aortic dissection: analysis of risk factors in 487 consecutive patients Eur. Heart J., January 2, 2005; 26(2): 180 - 186. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Kallenbach, T. Oelze, R. Salcher, C. Hagl, M. Karck, R. G. Leyh, and A. Haverich Evolving Strategies for Treatment of Acute Aortic Dissection Type A Circulation, September 14, 2004; 110(11_suppl_1): II-243 - II-249. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Kallenbach, R.G. Leyh, R. Salcher, M. Karck, C. Hagl, and A. Haverich Acute aortic dissection versus aortic root aneurysm: comparison of indications for valve sparing aortic root reconstruction Eur. J. Cardiothorac. Surg., May 1, 2004; 25(5): 663 - 670. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. T. Lai, D. C. Miller, R. S. Mitchell, P. E. Oyer, K. A. Moore, R. C. Robbins, N. E. Shumway, and B. A. Reitz Acute type a aortic dissection complicated by aortic regurgitation: composite valve graft versus separate valve graft versus conservative valve repair J. Thorac. Cardiovasc. Surg., December 1, 2003; 126(6): 1978 - 1985. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. G. Leyh, S. Fischer, K. Kallenbach, T. Kofidis, K. Pethig, W. Harringer, and A. Haverich High Failure Rate After Valve-sparing Aortic Root Replacement Using the "Remodeling Technique" in Acute Type A Aortic Dissection Circulation, September 24, 2002; 106(12_suppl_1): I-229 - I-233. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Kallenbach, K. Pethig, R.G. Leyh, D. Baric, A. Haverich, and W. Harringer Acute dissection of the ascending aorta: first results of emergency valve sparing aortic root reconstruction Eur. J. Cardiothorac. Surg., August 1, 2002; 22(2): 218 - 222. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Bachet Acute type A aortic dissection: can we dramatically reduce the surgical mortality? Ann. Thorac. Surg., March 1, 2002; 73(3): 701 - 703. [Full Text] [PDF]
|
|
|
|
|
|
T. Murashita, T. Kunihara, N. Shiiya, H. Aoki, K. Myojin, and K. Yasuda Is preservation of the aortic valve different between acute and chronic type A aortic dissections? Eur. J. Cardiothorac. Surg., November 1, 2001; 20(5): 967 - 972. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Michielon, L. Salvador, U. Da Col, and C. Valfre Modified button-Bentall operation for aortic root replacement: the miniskirt technique Ann. Thorac. Surg., September 1, 2001; 72(3): S1059 - 1064. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Kazui, N. Washiyama, Abul Hasan Muhammad Bashar, H. Terada, K. Suzuki, K. Yamashita, and M. Takinami Role of biologic glue repair of proximal aortic dissection in the development of early and midterm redissection of the aortic root Ann. Thorac. Surg., August 1, 2001; 72(2): 509 - 514. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. R. Moon, T. M. Sundt III, M. K. Pasque, H. B. Barner, C. B. Huddleston, R. J. Damiano Jr, and W. A. Gay Jr Does the extent of proximal or distal resection influence outcome for type A dissections? Ann. Thorac. Surg., April 1, 2001; 71(4): 1244 - 1249. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Sinatra, G. Melina, I. Pulitani, B. Fiorani, G. Ruvolo, and B. Marino Emergency operation for acute type A aortic dissection: neurologic complications and early mortality Ann. Thorac. Surg., January 1, 2001; 71(1): 33 - 38. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. P. Graeter, F. Langer, N. Nikoloudakis, D. Aicher, and H.-J. Schafers Valve-preserving operation in acute aortic dissection type A Ann. Thorac. Surg., November 1, 2000; 70(5): 1460 - 1465. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. P. Casselman, M. E. S.H. Tan, F. E.E. Vermeulen, J. C. Kelder, W. J. Morshuis, and M. A.A.M. Schepens Durability of aortic valve preservation and root reconstruction in acute type A aortic dissection Ann. Thorac. Surg., October 1, 2000; 70(4): 1227 - 1233. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. D. Movsowitz, R. A. Levine, A. D. Hilgenberg, and E. M. Isselbacher Transesophageal echocardiographic description of the mechanisms of aortic regurgitation in acute type A aortic dissection: implications for aortic valve repair J. Am. Coll. Cardiol., September 1, 2000; 36(3): 884 - 890. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
U. Niederhauser, H. Rudiger, A. Kunzli, B. Seifert, J. Schmidli, P. Vogt, and M. Turina Surgery for acute type a aortic dissection: comparison of techniques Eur. J. Cardiothorac. Surg., September 1, 2000; 18(3): 307 - 312. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. G. Leyh, C. Schmidtke, C. Bartels, and H.-H. Sievers Valve-sparing aortic root replacement (remodeling/reimplantation) in acute type A dissection Ann. Thorac. Surg., July 1, 2000; 70(1): 21 - 24. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. A. Bingley, M. A.H. Gardner, E. G. Stafford, T. K. Mau, P. G. Pohlner, R. K.W. Tam, H. Jalali, P. J. Tesar, and M. F. O'Brien Late complications of tissue glues in aortic surgery Ann. Thorac. Surg., June 1, 2000; 69(6): 1764 - 1768. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. F. Sabik, B. W. Lytle, E. H. Blackstone, P. M. McCarthy, F. D. Loop, and D. M. Cosgrove Long-term effectiveness of operations for ascending aortic dissections J. Thorac. Cardiovasc. Surg., May 1, 2000; 119(5): 946 - 962. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. G. Svensson, J. Longoria, W. A. Kimmel, and E. Nadolny Management of aortic valve disease during aortic surgery Ann. Thorac. Surg., March 1, 2000; 69(3): 778 - 783. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. M. Langley, S. J. Rooney, M. J. R. Dalrymple-Hay, J. M. F. Spencer, M. E. Lewis, D. Pagano, M. Asif, J. R. Goddard, V. T. Tsang, R. K. Lamb, et al. REPLACEMENT OF THE PROXIMAL AORTA AND AORTIC VALVE USING A COMPOSITE BILEAFLET PROSTHESIS AND GELATIN-IMPREGNATED POLYESTER GRAFT (CARBO-SEAL): EARLY RESULTS IN 143 PATIENTS J. Thorac. Cardiovasc. Surg., December 1, 1999; 118(6): 1014 - 1020. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. B. Luciani, G. Casali, A. Tomezzoli, and A. Mazzucco Recurrence of aortic insufficiency after aortic root remodeling with valve preservation Ann. Thorac. Surg., June 1, 1999; 67(6): 1849 - 1852. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Bachet, B. Goudot, G. D. Dreyfus, D. Brodaty, C. Dubois, P. Delentdecker, and D. Guilmet Surgery for acute type A aortic dissection: the Hopital Foch experience (1977-1998) Ann. Thorac. Surg., June 1, 1999; 67(6): 2006 - 2009. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Pessotto, F. Santini, P. Pugliese, G. Montalbano, G. B. Luciani, G. Faggian, P. Bertolini, and A. Mazzucco Preservation of the aortic valve in acute type A dissection complicated by aortic regurgitation Ann. Thorac. Surg., June 1, 1999; 67(6): 2010 - 2013. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
U. Niederhauser, A. Kunzli, B. Seifert, J. Schmidli, M. Lachat, G. Zund, P. Vogt, and M. Turina Conservative treatment of the aortic root in acute type a dissection Eur. J. Cardiothorac. Surg., May 1, 1999; 15(5): 557 - 563. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
O. M. Shapira, G. S. Aldea, S. M. Cutter, C. A. Fitzgerald, A.N.P. H. L. Lazar, and R. J. Shemin Improved clinical outcomes after operation of the proximal aorta: a 10-year experience Ann. Thorac. Surg., April 1, 1999; 67(4): 1030 - 1037. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. M. Dossche, M. A.A.M. Schepens, W. J. Morshuis, A. B. de la Riviere, P. J. Knaepen, and F. E.E. Vermeulen A 23-year experience with composite valve graft replacement of the aortic root Ann. Thorac. Surg., April 1, 1999; 67(4): 1070 - 1077. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. M. Gillinov, B. W. Lytle, R. J. Kaplon, F. P. Casselman, E. H. Blackstone, and D. M. Cosgrove DISSECTION OF THE ASCENDING AORTA AFTER PREVIOUS CARDIAC SURGERY: DIFFERENCES IN PRESENTATION AND MANAGEMENT J. Thorac. Cardiovasc. Surg., February 1, 1999; 117(2): 252 - 260. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 V. J. Weiss and R. B. Smith III Peripheral Vascular Manifestations of Aortic Dissection: Recognition and Management Perspectives in Vascular Surgery and Endovascular Therapy, January 1, 1999; 10(2): 27 - 41. [Abstract] [PDF]
|
|
|
|
|
|
H. J. Safi, C. C. Miller III, M. J. Reardon, D. C. Iliopoulos, G. V. Letsou, R. Espada, and J. C. Baldwin Operation for acute and chronic aortic dissection: recent outcome with regard to neurologic deficit and early death Ann. Thorac. Surg., August 1, 1998; 66(2): 402 - 411. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Westaby, T. Katsumata, R. Houel, and A. Shinfeld Stentless Xenograft Repair of the Dissected Aortic Root Ann. Thorac. Surg., May 1, 1998; 65(5): 1448 - 1450. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
U. Niederhauser, H. Rudiger, P. Vogt, A. Kunzli, G. Zund, and M. Turina Composite graft replacement of the aortic root in acute dissection Eur. J. Cardiothorac. Surg., February 1, 1998; 13(2): 144 - 150. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Westaby, T. Katsumata, and E. Freitas Aortic Valve Conservation in Acute Type A Dissection Ann. Thorac. Surg., October 1, 1997; 64(4): 1108 - 1112. [Abstract] [Full Text]
|
|
|
|
|
|
C. Yamashita, M. Okada, K. Ataka, M. Yoshida, N. Yoshimura, T. Azami, K. Nakagiri, H. Wakiyama, and T. Yamashita Open Distal Anastomosis in Retrograde Cerebral Perfusion for Repair of Ascending Aortic Dissection Ann. Thorac. Surg., September 1, 1997; 64(3): 665 - 669. [Abstract] [Full Text]
|
|
|
|
|
|
L. H. Cohn, R. J. Rizzo, D. H. Adams, S. F. Aranki, G. S. Couper, N. Beckel, and J. J. Collins Jr Reduced Mortality and Morbidity for Ascending Aortic Aneurysm Resection Regardless of Cause Ann. Thorac. Surg., August 1, 1996; 62(2): 463 - 468. [Abstract] [Full Text]
|
|
|
|
|
|
L. K. von Segesser, E. Lorenzetti, M. Lachat, U. Niederhauser, M. Schonbeck, P. R. Vogt, and M. I. Turina AORTIC VALVE PRESERVATION IN ACUTE TYPE A DISSECTION: IS IT SOUND? J. Thorac. Cardiovasc. Surg., February 1, 1996; 111(2): 381 - 391. [Abstract] [Full Text]
|
|
|
|
|
|
J. I. Fann, J. A. Smith, D. C. Miller, R. S. Mitchell, K. A. Moore, G. Grunkemeier, E. B. Stinson, P. E. Oyer, B. A. Reitz, and N. E. Shumway Surgical Management of Aortic Dissection During a 30-Year Period Circulation, November 1, 1995; 92(9): 113 - 121. [Abstract] [Full Text]
|
|
|
|
|
|
J. E. Bachet, J.-L. Termignon, G. Dreyfus, B. Goudot, L. Martinelli, A. Piquois, D. Brodaty, C. Dubois, P. Delentdecker, and D. Guilmet Aortic dissectionPrevalence, cause, and results of late reoperations J. Thorac. Cardiovasc. Surg., August 1, 1994; 108(2): 199 - 206. [Abstract] [Full Text]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
