Aortic root replacement with composite valve graft

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Aortic root replacement with composite valve graft Davide Pacini, MD, Federico Ranocchi, MD, Emanuela Angeli, MD, Fabrizio Settepani, MD, Marco Pagliaro, MD, Sofia Martin-Suarez, MD, Roberto Di Bartolomeo, MD, Angelo Pierangeli, MD The Annals of Thoracic Surgery Volume 76, Issue 1, Pages 90-98 (July 2003) DOI: 10.1016/S0003-4975(03)00265-0

Fig 1 Actuarial survival rates (including hospital mortality) of the 274 patients. Percent survival ± SE is 88.6 ± 1.9 at 1 year, 77.7 ± 2.9 at 5 years, 63.0 ± 4.3 at 10 years, 54.7 ± 5.1 at 15 years, and 33.4 ± 8.2 at 20 years. Number of patients at risk at yearly intervals for years 0 through 20, respectively, is 274, 228, 184, 149, 127, 106, 92, 73, 65, 57, 53, 40, 34, 26, 18, 16, 15, 13, 9, 2, and 2. The Annals of Thoracic Surgery 2003 76, 90-98DOI: (10.1016/S0003-4975(03)00265-0)

Fig 2 (A) Actuarial survival rates of the patients with Marfan syndrome (dashed lines) and without Marfan syndrome (solid lines); the difference between the two groups was not significant (p = 0.785). Percent survival ± SE for patients with Marfan syndrome is 94.3 ± 3.9 at 1 year, 80.6 ± 8.3 at 5 years, 70.6 ± 11.9 at 10 years, 29.4 ± 16.4 at 15 years, and 0 at 20 years; number of patients at risk yearly for years 0 through 16, respectively, is 35, 30, 26, 22, 17, 13, 12, 9, 9, 8, 6, 3, 3, 2, 1, 1, and 1. Percent survival for no Marfan syndrome is 87.8 ± 2.1 at 1 year, 77.3 ± 3.1 at 5 years, 62.0 ± 4.6 at 10 years, 57.7 ± 5.2 at 15 years, and 37.6 ± 8.9 at 20 years; number of patients at risk yearly for years 0 through 20, respectively, is 239, 198, 156, 126, 110, 92, 79, 64, 56, 49, 47, 37, 30, 24, 17, 15, 14, 14, 9, 2, and 2. (B) Comparison of actuarial survival of patients with aortic dissection (dashed lines) and without aortic dissection (solid lines; p = 0.106). Percent survival with aortic dissection is 91.3 ± 4.2 at 1 year, 63.0 ± 8.5 at 5 years, 53.6 ± 9.5 at 10 years, 38.1 ± 11.8 at 15 years, and 25.4 ± 13.0 at 20 years; number of patients at risk yearly for years 0 through 20, respectively, is 46, 40, 32, 24, 21, 16, 15, 14, 12, 12, 10, 6, 5, 4, 3, 3, 2, 2, 2, 1, and 1. Percent survival for all other patients is 88.1 ± 2.2 at 1 year, 80.1 ± 3.0 at 5 years, 65.0 ± 4.8 at 15 years, 58.7 ± 5.6 at 15 years, and 33.8 ± 10.1 at 20 years; number of patients at risk yearly for years 0 through 20, respectively, is 288, 188, 150, 124, 106, 88, 76, 59, 52, 45, 43, 33, 28, 22, 15, 13, 12, 12, 7, 1, and 1. The Annals of Thoracic Surgery 2003 76, 90-98DOI: (10.1016/S0003-4975(03)00265-0)

Fig 3 (A) Actuarial freedom from thromboembolism. Percent of patients free of thromboembolism ± SE is 99.6 ± 0.4 at 1 year, 98.2 ± 1.1 at 5 years, 90.9 ± 3.1 at 10 years, 90.0 ± 3.1 at 15 years, and 90.0 ± 3.1 at 20 years. Number of patients at risk yearly for years 0 through 20, respectively, is 274, 228, 182, 147, 126, 103, 89, 73, 65, 57, 52, 39, 32, 25, 17, 15, 14, 13, 8, 1, and 1. (B) Actuarial freedom from anticoagulant-related hemorrhage. Percent of patients free of hemorrhage is 100 at 1 year, 99.6 ± 0.5 at 5 years, 87.4 ± 3.7 at 10 years, 81.9 ± 6.3 at 15 years, and 73.7 ± 9.6 at 20 years. Number of patients at risk yearly for years 0 through 20, respectively, is 274, 228, 183, 148, 127, 105, 91, 72, 63, 55, 51, 40, 33, 26, 18, 15, 14, 13, 8, 2, and 2. The Annals of Thoracic Surgery 2003 76, 90-98DOI: (10.1016/S0003-4975(03)00265-0)

Fig 4 (A) Actuarial freedom from prosthetic endocarditis. Percent of patients free of prosthetic endocarditis ± SE is 98.8 ± 0.7 at 1 year, 98.2 ± 0.9 at 5 years, 96.4 ± 2.0 at 10 years, 96.8 ± 2.0 at 15 years, and 96.8 ± 2.0 at 20 years. Number of patients at risk yearly for years 0 through 20, respectively, is 274, 225, 181, 146, 125, 102, 88, 71, 62, 53, 42, 39, 32, 25, 17, 14, 13, 12, 7, 1, and 1. (B) Actuarial freedom from reoperation for pseudoaneurysms according to the operative technique: classic Bentall technique (dashed lines) and “button” technique (solid lines; p = 0.776). Percent of Bentall patients free of pseudoaneurysms is 98.8 ± 1.2 at 1 year, 98.8 ± 1.2 at 5 years, 98.8 ± 1.2 at 10 years, 93.9 ± 4.9 at 15 years, and 93.9 ± 4.9 at 20 years; number of patients at risk yearly for years 0 through 20, respectively, is 94, 83, 77, 75, 73, 70, 68, 68, 63, 56, 53, 40, 33, 26, 18, 16, 15, 14, 9, 2, and 2. Percent of button technique patients free of pseudoaneurysms is 100 at 1 year, 98.8 ± 1.2 at 5 years, and 95.5 ± 3.5 at 10 years; number of patients at risk at yearly intervals for years 0 through 8, respectively, is 172, 140, 101, 70, 51, 31, 21, 4, and 1. The Annals of Thoracic Surgery 2003 76, 90-98DOI: (10.1016/S0003-4975(03)00265-0)

Fig 5 Actuarial freedom from valve graft related complications. Percent of patients free of complications ± SE is 97.9 ± 0.9 at 1 year, 96.0 ± 1.5 at 5 years, 81.0 ± 4.3 at 10 years, 71.6 ± 7.3 at 15 years, and 63.6 ± 10.0 at 20 years. Number of patients at risk yearly for years 0 through 20, respectively, is 274, 226, 182, 147, 126, 103, 89, 72, 63, 54, 49, 39, 32, 25, 17, 14, 13, 12, 7, 1, and 1. The Annals of Thoracic Surgery 2003 76, 90-98DOI: (10.1016/S0003-4975(03)00265-0)

Fig 6 Actuarial freedom from reoperation on the thoracic or abdominal aorta or both in patients with Marfan syndrome (dashed lines) and without Marfan syndrome (solid lines); the difference between the two groups was statistically significant (p = 0.008). Percent of Marfan patients free of reoperation ± SE is 100 at 1 year, 92.9 ± 6.9 at 5 years, 79.6 ± 13.6 at 10 years, 53.1 ± 23.5 at 15 years, and 0 at 20 years; number of patients at risk yearly for years 0 through 16, respectively, is 35, 30, 26, 22, 17, 13, 12, 9, 9, 7, 6, 3, 3, 2, 1, 1, and 1. Percent of non-Marfan patients free of reoperation is 99.5 ± 0.4 at 1 year, 98.8 ± 0.9 at 5 years, 94.6 ± 2.6 at 10 years, 87.6 ± 5.7 at 15 years, and 87.6 ± 5.7 at 20 years; number of patients at risk yearly for years 0 through 20, respectively, is 239, 198, 157, 126, 110, 92, 79, 64, 56, 49, 46, 37, 30, 24, 17, 15, 14, 14, 8, 2, and 2. The Annals of Thoracic Surgery 2003 76, 90-98DOI: (10.1016/S0003-4975(03)00265-0)