These tools will no longer be maintained as of December 31, 2024. Archived website can be found here. PubMed4Hh GitHub repository can be found here. Contact NLM Customer Service if you have questions.


Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

  • Title: Aortic root replacement with a composite graft. Factors influencing immediate and long-term results.
    Author: Bachet J, Termignon JL, Goudot B, Dreyfus G, Piquois A, Brodaty D, Dubois C, Delentdecker P, Guilmet D.
    Journal: Eur J Cardiothorac Surg; 1996; 10(3):207-13. PubMed ID: 8664022.
    Abstract:
    From April 73 to June 94, 203 patients (167 men, 36 women) aged from 10 to 74 years (mean: 44.8 +/- 15) underwent ascending aortic replacement with composite graft for: dystrophic aneurysm (AN) (130 cases, 64.5%), chronic dissection (CD) (35 cases, 17.2%), type A acute dissection (AD) (38 cases, 18.7%). Forty-six patients (22.6%) suffered from Marfan syndrome (24 AN, 13 AD, 9 CD). Thirty patients (14.7%) had undergone a previous cardiac or aortic operation. The ascending aortic replacement was extended to the transverse arch in 28 patients (13.7%). A mechanical valve was used in 193 cases (95%). Since 1986, the ascending aorta has been totally resected and a gelatin-or collagen-coated vascular prosthesis used. The technique of coronary reattachment has varied with time and according to the aortic lesions. The classic "Bentall" technique was used in 87 patients (43%), the "button" technique in 74 (36%), the "Cabrol" technique in 26 (13%) and a "mixed" technique in 16 cases (8%). The hospital mortality rate was 7.3% (15/203) (AN: 2.3%, CD: 11.4%, AD: 21%). The only predictors of hospital death were emergency AD (P < 0.03) and arch replacement (P < 0.02). Mean follow-up was 46 +/- 10 months (2-246). The overall long-term survival rate was (Kaplan Meier) 89 +/- 6% at 1 year, 77.9 +/- 9% at 5 years, 67.7 +/- 12% at 10 years and 61.3 +/- 15% at 12 years. The 10-year survival rate is significantly higher in patients with AN (77.8 +/- 11%) than in those with AD (61.6 +/- 17%) (log. rank: P < 0.01). The late survival rate is also significantly higher after the "button" or Bentall reimplantation than after the "Cabrol" or "mixed" methods (90 +/- 5% in the "button" group and 88.7 +/- 6%, 83.8 +/- 9% and 76.6 +/- 12% in the "Bentall" group vs 80 +/- 18%, 63 +/- 21% and 58 +/- 35% in the "Cabrol" group at 1, 5 and 8 years, respectively). In conclusion, ascending aortic replacement with a composite graft is a safe procedure especially when performed electively in patients with dystrophic aneurysm or Marfan syndrome. The technique of coronary reimplantation has a significant influence on the long-term results. The reimplantation of choice is the "button" technique, especially in the presence of a fragile aortic wall (AD). The "Cabrol" technique must be used when the "button" or the "Bentall" reimplantation is not feasible, for instance during redo procedures.
    [Abstract] [Full Text] [Related] [New Search]