| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
The Journal of Thoracic and Cardiovascular Surgery, Vol 92, 691-705, Copyright © 1986 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
NT Kouchoukos, WG Marshall Jr and TA Wedige-Stecher
Between September, 1974, and December, 1985, 127 patients had replacement
of the ascending aorta and aortic valve with a composite graft.
Annuloaortic ectasia was the most common indication for operation (69
patients), followed by aortic dissection (51 patients). Twenty-four
patients (19%) had the Marfan syndrome. Hospital mortality was 4.7%.
Emergent operation for acute dissection was the only independent predictor
of hospital death (p = 0.03). Reoperation for postoperative hemorrhage was
required in 15 patients (11.8%) and for prosthesis-related complications
(pseudoaneurysm, prosthetic endocarditis, technical problems, and valve
thrombosis) in 16 patients (12.6%). Since we adopted a technique of
preclotting the prosthesis with whole blood or albumin plus autoclaving and
abandoned the inclusion technique, the reoperation rate has declined
substantially. At 5 years, the actuarial freedom from reoperation for any
reason on the ascending aorta or aortic valve for the 24 patients in whom
this modification was used was 90% and for the remaining 103 patients, 73%
(p = 0.17). No reoperations for pseudoaneurysms or technical problems were
required in these 24 patients, whereas 10 reoperations for these
complications were necessary in the other patients. The mean duration of
follow-up was 54 months. The actuarial survival rate at 7 years for the
entire group was 65%; for the patients with annuloaortic ectasia, 70%; for
those with aortic dissection, 61%; for the patients with the Marfan
syndrome, 57%. Actuarial freedom from operation on the remainder of the
aorta at 7 years was 89%, but it was 78% for the subgroup with the Marfan
syndrome. The satisfactory results with extended follow-up support the
continued use of the composite graft technique as the preferred method of
treatment for patients with annuloaortic ectasia or recurrent aneurysms of
the sinuses of Valsalva and for patients with aortic dissection who require
aortic valve replacement.
ARTICLES
Eleven-year experience with composite graft replacement of the ascending aorta and aortic valve
This article has been cited by other articles:
|
|
 |
|
  K. Okamoto, F. P. Casselman, R. De Geest, and H. Vanermen Giant left coronary ostial aneurysm after modified Bentall procedure in a Marfan patient Interactive CardioVascular and Thoracic Surgery, December 1, 2008; 7(6): 1164 - 1166. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Tsunekawa, H. Ogino, H. Matsuda, K. Minatoya, H. Sasaki, J. Kobayashi, T. Yagihara, and S. Kitamura Composite Valve Graft Replacement of the Aortic Root: Twenty-Seven Years of Experience at One Japanese Center Ann. Thorac. Surg., November 1, 2008; 86(5): 1510 - 1517. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Nezic, M. Cirkovic, A. Knezevic, and M. Jovic Modified Bentall procedure - 'a collar technique' to control bleeding from coronary ostia anastomoses Interactive CardioVascular and Thoracic Surgery, August 1, 2008; 7(4): 709 - 711. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. D. Patel, E. S. Weiss, D. E. Alejo, L. U. Nwakanma, J. A. Williams, H. C. Dietz, P. J. Spevak, V. L. Gott, L. A. Vricella, and D. E. Cameron Aortic root operations for marfan syndrome: a comparison of the bentall and valve-sparing procedures. Ann. Thorac. Surg., June 1, 2008; 85(6): 2003 - 2011. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. D. Desai and G. T. Christakis Bioprosthetic Aortic Valve Replacement: Stented Pericardial and Porcine Valves Card. Surg. Adult, January 1, 2008; 3(2008): 857 - 894. [Full Text]
|
|
|
|
|
|
D. R. Brinster, R. J. Rizzo, and R. M. Bolman III Ascending Aortic Aneurysms Card. Surg. Adult, January 1, 2008; 3(2008): 1223 - 1250. [Full Text]
|
|
|
|
|
|
T. B. Reece, R. R. Singh, B. M. Stiles, B. B. Peeler, J. A. Kern, C. G. Tribble, and I. L. Kron Replacement of the Proximal Aorta Adds No Further Risk to Aortic Valve Procedures Ann. Thorac. Surg., August 1, 2007; 84(2): 473 - 478. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Taniguchi, S. Kuki, T. Takahashi, T. Masai, K. Toda, H. Matsue, and H. Hata Simple and Uniform Technique for Combined Repair of Aortic Arch and Root Replacement Ann. Thorac. Surg., August 1, 2007; 84(2): 677 - 679. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Matsumori, H. Tanaka, Y. Kawanishi, T. Onishi, K. Nakagiri, T. Yamashita, K. Okada, and Y. Okita Comparison of distensibility of the aortic root and cusp motion after aortic root replacement with two reimplantation techniques: Valsalva graft versus tube graft Interactive CardioVascular and Thoracic Surgery, April 1, 2007; 6(2): 177 - 181. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. N. Girardi, K. H. Krieger, C. A. Mack, L. Y. Lee, A. J. Tortolani, and O. W. Isom Reoperations on the ascending aorta and aortic root in patients with previous cardiac surgery. Ann. Thorac. Surg., October 1, 2006; 82(4): 1407 - 1412. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. Hirasawa, S. Aomi, S. Saito, S. Kihara, H. Tomioka, and H. Kurosawa Long-term results of modified Bentall procedure using flanged composite aortic prosthesis and separately interposed coronary graft technique Interactive CardioVascular and Thoracic Surgery, October 1, 2006; 5(5): 574 - 577. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. D. Patel, J. A. Williams, C. J. Barreiro, B. T. Bethea, T. P. Fitton, H. C. Dietz, J. A.C. Lima, P. J. Spevak, V. L. Gott, L. A. Vricella, et al. Valve-Sparing Aortic Root Replacement: Early Experience With the De Paulis Valsalva Graft in 51 Patients Ann. Thorac. Surg., August 1, 2006; 82(2): 548 - 553. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T Vydt, J Coddens, and F Wellens Superior vena cava syndrome caused by a pseudoaneurysm of the ascending aorta Heart, April 1, 2005; 91(4): e29 - e29. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. T. Strauch, D. Spielvogel, S. L. Lansman, A. L. Lauten, C. Bodian, and R. B. Griepp Long-Term Integrity of Teflon Felt-Supported Suture Lines in Aortic Surgery Ann. Thorac. Surg., March 1, 2005; 79(3): 796 - 800. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. P Urbanski, W. Dinstak, S. Frank, A. Siebel, and R. W Hacker Modified versus Standard Mechanical Valved Aortic Conduit Asian Cardiovasc Thorac Ann, March 1, 2005; 13(1): 53 - 57. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. G. Byrne, A. N. Karavas, M. Leacche, D. Unic, J. D. Rawn, G. S. Couper, T. Mihaljevic, R. J. Rizzo, S. F. Aranki, and L. H. Cohn Impact of Concomitant Coronary Artery Bypass Grafting on Hospital Survival After Aortic Root Replacement Ann. Thorac. Surg., February 1, 2005; 79(2): 511 - 516. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Wiesenack, M. Arlt, A. Liebold, and F. X. Schmid Successful use of one dose of recombinant factor VIIa to control severe bleeding after emergency aortic arch replacement in deep hypothermic circulatory arrest J. Thorac. Cardiovasc. Surg., December 1, 2004; 128(6): 941 - 943. [Full Text] [PDF]
|
|
|
|
|
|
B. T. Bethea, T. P. Fitton, D. E. Alejo, C. J. Barreiro, S. M. Cattaneo, H. C. Dietz, P. J. Spevak, J. A. C. Lima, V. L. Gott, and D. E. Cameron Results of aortic valve-sparing operations: Experience with remodeling and reimplantation procedures in 65 patients Ann. Thorac. Surg., September 1, 2004; 78(3): 767 - 772. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Sioris, T. E. David, J. Ivanov, S. Armstrong, and C. M. Feindel Clinical outcomes after separate and composite replacement of the aortic valve and ascending aorta J. Thorac. Cardiovasc. Surg., August 1, 2004; 128(2): 260 - 265. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J.-P. E. Kvitting, T. Ebbers, L. Wigstrom, J. Engvall, C. L. Olin, and A. F. Bolger Flow patterns in the aortic root and the aorta studied with time-resolved, 3-dimensional, phase-contrast magnetic resonance imaging: Implications for aortic valve-sparing surgery J. Thorac. Cardiovasc. Surg., June 1, 2004; 127(6): 1602 - 1607. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Furukawa, H. Ohteki, Z.-L. Cao, Y. Narita, Y. Okazaki, S. Ohtsubo, and T. Itoh Evaluation of native valve-sparing aortic root reconstruction with direct imaging-- reimplantation or remodeling? Ann. Thorac. Surg., May 1, 2004; 77(5): 1636 - 1641. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Motallebzadeh, D. Batas, O. Valencia, V. Chandrasekaran, J. Smith, S. Brecker, and M. Jahangiri The role of coronary angiography in acute type A aortic dissection Eur. J. Cardiothorac. Surg., February 1, 2004; 25(2): 231 - 235. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Angeli, D. Pacini, G. Napoli, R. D. Bartolomeo, R. Fattori, and A. Pierangeli Cardiac Anomalies in Turner Syndrome Asian Cardiovasc Thorac Ann, December 1, 2003; 11(4): 349 - 351. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Kazui, K. Yamashita, H. Terada, N. Washiyama, T. Suzuki, K. Ohkura, and K. Suzuki Late reoperation for proximal aortic and arch complications after previous composite graft replacement in marfan patients Ann. Thorac. Surg., October 1, 2003; 76(4): 1203 - 1207. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. D. Milano, S. Pratali, G. Mecozzi, P. Boraschi, G. Braccini, E. Magagnini, and U. Bortolotti Fate of coronary ostial anastomoses after the modified Bentall procedure Ann. Thorac. Surg., June 1, 2003; 75(6): 1797 - 1801. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. D. Desai and G. T. Christakis Stented Mechanical/Bioprosthetic Aortic Valve Replacement Card. Surg. Adult, January 1, 2003; 2(2003): 825 - 856. [Full Text]
|
|
|
|
|
|
C. A. Anderson, R. J. Rizzo, and L. H. Cohn Ascending Aortic Aneurysms Card. Surg. Adult, January 1, 2003; 2(2003): 1123 - 1148. [Full Text]
|
|
|
|
|
|
K. Kallenbach, C. Hagl, T. Walles, R. G. Leyh, K. Pethig, A. Haverich, and W. Harringer Results of valve-sparing aortic root reconstruction in 158 consecutive patients Ann. Thorac. Surg., December 1, 2002; 74(6): 2026 - 2033. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Harada, T. Ito, T. Mawatari, and T. Abe Replacement of a thrombosed valve after the Bentall procedure Ann. Thorac. Surg., March 1, 2002; 73(3): 965 - 967. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. L. Gott, D. E. Cameron, D. E. Alejo, P. S. Greene, J. G. Shake, D. J. Caparrelli, and H. C. Dietz Aortic root replacement in 271 Marfan patients: a 24-year experience Ann. Thorac. Surg., February 1, 2002; 73(2): 438 - 443. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P Riley, S Rooney, R Bonser, and P Guest Imaging the post-operative thoracic aorta: normal anatomy and pitfalls Br. J. Radiol., December 1, 2001; 74(888): 1150 - 1158. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Panos, B. Amahzoune, J. Robin, G. Champsaur, and J. Ninet Influence of technique of coronary artery implantation on long-term results in composite aortic root replacement Ann. Thorac. Surg., November 1, 2001; 72(5): 1497 - 1501. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Ingu, M. Ando, Y. Okita, N. Yamada, and S. Kitamura Redo operation for thoracoaortic aneurysm after entire aortic replacement Ann. Thorac. Surg., November 1, 2001; 72(5): 1766 - 1767. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. T. Kouchoukos, P. Masetti, C. K. Rokkas, and S. F. Murphy Single-stage reoperative repair of chronic type A aortic dissection by means of the arch-first technique J. Thorac. Cardiovasc. Surg., September 1, 2001; 122(3): 578 - 582. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Kallenbach, K. Pethig, M. Schwarz, A. Milz, A. Haverich, and W. Harringer Valve sparing aortic root reconstruction versus composite replacement - perioperative course and early complications Eur. J. Cardiothorac. Surg., July 1, 2001; 20(1): 77 - 81. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Peters, C. F. Hughes, E. Ikeda, and J. C. Mackie Toxic fumes from use of cautery on collagen- and gelatin-impregnated polyester vascular grafts J. Thorac. Cardiovasc. Surg., February 1, 2001; 121(2): 0384 - 386. [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]
|
|
|
|
|
|
R. Di Bartolomeo, D. Pacini, M. Di Eusanio, and A. Pierangeli Antegrade selective cerebral perfusion during operations on the thoracic aorta: our experience Ann. Thorac. Surg., July 1, 2000; 70(1): 10 - 15. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Westaby, T. Katsumata, and G. Vaccari Aortic root replacement with coronary button re-implantation: low risk and predictable outcome Eur. J. Cardiothorac. Surg., March 1, 2000; 17(3): 259 - 265. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Ando, Y. Kosakai, Y. Okita, K. Nakano, and S. Kitamura Surgical treatment of behcet’s disease involving aortic regurgitation Ann. Thorac. Surg., December 1, 1999; 68(6): 2136 - 2140. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. B. Luciani, G. Casali, L. Barozzi, and A. Mazzucco Aortic root replacement with the Carboseal composite graft: 7-year experience with the first 100 implants Ann. Thorac. Surg., December 1, 1999; 68(6): 2258 - 2262. [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]
|
|
|
|
|
|
M. Piciche, R. De Paulis, and L. Chiariello Unusual origin and fistulization of an aortic pseudoaneurysm: ""off-pump"" surgical repair Ann. Thorac. Surg., October 1, 1999; 68(4): 1406 - 1407. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. A. Ergin, D. Spielvogel, A. Apaydin, S. L. Lansman, J. N. McCullough, J. D. Galla, and R. B. Griepp Surgical treatment of the dilated ascending aorta: when and how? Ann. Thorac. Surg., June 1, 1999; 67(6): 1834 - 1839. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. A. M. van Son, R. Battellini, M. Mierzwa, T. Walther, R. Autschbach, and F. W. Mohr AORTIC ROOT RECONSTRUCTION WITH PRESERVATION OF NATIVE AORTIC VALVE AND SINUSES IN AORTIC ROOT DILATATION WITH AORTIC REGURGITATION J. Thorac. Cardiovasc. Surg., June 1, 1999; 117(6): 1151 - 1155. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. B. Devereux and M. J. Roman Aortic Disease in Marfan's Syndrome N. Engl. J. Med., April 29, 1999; 340(17): 1358 - 1359. [Full Text]
|
|
|
|
|
|
C. Detter, H. Mair, H.-G. Klein, C. Georgescu, A. Welz, and B. Reichart Long-term prognosis of surgically-treated aortic aneurysms and dissections in patients with and without Marfan syndrome Eur. J. Cardiothorac. Surg., April 1, 1999; 13(4): 416 - 423. [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]
|
|
|
|
 |
|
 M. Demircin, R. Dogan, M. Guvener, M. Yilmaz, A. Celiker, and I. Pasaoglu Replacement of Aortic Root with Valved Tubular Prosthesis in a Ten-Year-Old Child with Infective Endocarditis: A Case Report Angiology, November 1, 1998; 49(11): 941 - 944. [Abstract] [PDF]
|
|
|
|
|
|
I. L. Kron Surgery of the Thoracic Aorta Ann. Thorac. Surg., November 1, 1997; 64(5): 1555 - 1558. [Abstract] [Full Text]
|
|
|
|
|
|
L. N. Girardi, N. G. Talwalkar, and J. S. Coselli Aortic Root Replacement: Results Using the St. Jude Medical/Hemashield Composite Graft Ann. Thorac. Surg., October 1, 1997; 64(4): 1032 - 1035. [Abstract] [Full Text]
|
|
|
|
|
|
N. T. Kouchoukos and D. Dougenis Surgery of the Thoracic Aorta N. Engl. J. Med., June 26, 1997; 336(26): 1876 - 1889. [Full Text] [PDF]
|
|
|
|
|
|
A. D. Hilgenberg, C. W. Akins, D. L. Logan, G. J. Vlahakes, M. J. Buckley, J. C. Madsen, and D. F. Torchiana Composite Aortic Root Replacement With Direct Coronary Artery Implantation Ann. Thorac. Surg., October 1, 1996; 62(4): 1090 - 1095. [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]
|
|
|
|
|
|
P. Chevalier, E. Moncada, G. Kirkorian, and P. Touboul ACQUIRED AORTOPULMONARY FISTULA IN PSEUDOANEURYSM OF THE AORTA SIX YEARS AFTER A BENTALL OPERATION J. Thorac. Cardiovasc. Surg., October 1, 1995; 110(4): 1143 - 1144. [Full Text]
|
|
|
|
|
|
R. P. Cochran, K. S. Kunzelman, A. C. Eddy, B. O. Hofer, and E. D. Verrier Modified conduit preparation creates a pseudosinus in an aortic valve-sparing procedure for aneurysm of the ascending aorta J. Thorac. Cardiovasc. Surg., June 1, 1995; 109(6): 1049 - 1058. [Abstract] [Full Text]
|
|
|
|
|
|
V. L. Gott, A. M. Gillinov, R. E. Pyeritz, D. E. Cameron, B. A. Reitz, P. S. Greene, C. D. Stone, R. L. Ferris, D. E. Alejo, and V. A. McKusick Aortic root replacementRisk factor analysis of a seventeen-year experience with 270 patients J. Thorac. Cardiovasc. Surg., March 1, 1995; 109(3): 536 - 545. [Abstract] [Full Text]
|
|
|
|
|
|
F. Jault, P. Nataf, A. Rama, M. Fontanel, E. Vaissier, A. Pavie, V. Bors, C. Cabrol, and I. Gandjbakhch Chronic disease of the ascending aortaSurgical treatment and long-term results J. Thorac. Cardiovasc. Surg., October 1, 1994; 108(4): 747 - 754. [Abstract] [Full Text]
|
|
|
|
|
|
A. M. Gillinov, A. Hulyalkar, D. E. Cameron, P. W. Cho, P. S. Greene, B. A. Reitz, R. E. Pyeritz, and V. L. Gott Mitral valve operation in patients with the Marfan syndrome J. Thorac. Cardiovasc. Surg., March 1, 1994; 107(3): 724 - 731. [Abstract] [Full Text]
|
|
|
|
 |
|
 T. Kwan, M. S. Huber, and A. Feit Late Detection of Asymptomatic Chronic Perigraft Aortic Pseudoaneurysm: A Case Report Vascular and Endovascular Surgery, October 1, 1993; 27(8): 627 - 630. [Abstract] [PDF]
|
|
