Early results of valve sparing aortic root reconstruction in acute Stanford type A aortic dissection Mina Wahba, Said Soliman, Omar Dawoud, Alaaeldin.

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Presentation transcript:

Early results of valve sparing aortic root reconstruction in acute Stanford type A aortic dissection Mina Wahba, Said Soliman, Omar Dawoud, Alaaeldin Mohamed, Ahmed Daoud, Waleed Hussein. Cardiothoracic Surgery department, Faculty of Medicine, Benisuef university Cardiothoracic Surgery department, Faculty of Medicine, Cairo university

OBJECTIVE The aim of this study is to evaluate the early mortality and morbidities in acute ascending aortic dissection patients treated by aortic root reconstruction techniques.

METHODS This is a retrospective and prospective non randomized study including 30 patients in which aortic valve sparing and root reconstruction was done.

METHODS INCLUSION CRITERIA: - Acute Stanford type A aortic dissection - Left ventricular EF above 30% EXCLUSION CRITERIA: - Redo patients - Stanford type B aortic dissection - Patients undergoing replacement of ascending aorta plus other cardiac surgeries. - Patients with rheumatic aortic valve diseases.

RESULTS Mean age: 53±12 years Gender distribution: 21 males (70%) 9 females (30%)

RESULTS Aortic valve re-implantation: 19 patients

RESULTS One or two sinus replacement plus supra- commisuralconduit: 10 patients Remodelling technique: 1 patient

RESULTS Early mortality 6 (20%) Neurological complications 7(25%) Renal complications 10 (35.7%) Respiratory complications 5 (17.9%) Re-opening for bleeding

RESULTS Early mortality : 2 intra-operative mortalities, due to myocardial failure and massive uncontrollable bleeding. The other 4 patients died during the first 48 hours in I.C.U, 3 of them because of myocardial failure and one because of respiratory failure. Neurological complications : delayed recovery more than 24 hours in 4 patients and 3 patients with cerebro-vascular stroke one of which suffered permanent hemiplegia . Renal complications : Ten patients had renal impairment in the form of elevated creatinine, 3 of them needed one or two sessions of dialysis and resolved completely and only one patient became in need for regular dialysis .

RESULTS Post-operative echocardiography Aortic regurge Nil : 21 (75%) Trivial: 4 (14.3%) Mild: 3 (10.7%) Moderate: 0 Severe: 0

CONCLUSION: Our early results show excellent valvular stability without an increased operative risk. Freedom from anticoagulation and complete resection of diseased tissue represent unquestionable advantages of these techniques.

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