دورية أكاديمية
Additional cusp reconstruction does not compromise valve durability and mid-term survival after the David procedure: results from 449 patients.
العنوان: | Additional cusp reconstruction does not compromise valve durability and mid-term survival after the David procedure: results from 449 patients. |
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المؤلفون: | Liebrich M; Department of Cardiac Surgery, Sana Cardiac Surgery, Stuttgart, Germany., Charitos E; Department of Cardiac Surgery, University Hospital, Bonn, Germany., Stadler C; Department of Cardiac Surgery, Sana Cardiac Surgery, Stuttgart, Germany., Roser D; Department of Cardiac Surgery, Sana Cardiac Surgery, Stuttgart, Germany., Merk DR; Department of Cardiac Surgery, Sana Cardiac Surgery, Stuttgart, Germany., Doll N; Department of Cardiac Surgery, Sana Cardiac Surgery, Stuttgart, Germany., Hemmer W; Department of Cardiac Surgery, Sana Cardiac Surgery, Stuttgart, Germany., Voth V; Department of Cardiac Surgery, Sana Cardiac Surgery, Stuttgart, Germany. |
المصدر: | European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery [Eur J Cardiothorac Surg] 2020 Nov 01; Vol. 58 (5), pp. 1072-1079. |
نوع المنشور: | Journal Article |
اللغة: | English |
بيانات الدورية: | Publisher: Oxford University Press Country of Publication: Germany NLM ID: 8804069 Publication Model: Print Cited Medium: Internet ISSN: 1873-734X (Electronic) Linking ISSN: 10107940 NLM ISO Abbreviation: Eur J Cardiothorac Surg Subsets: MEDLINE |
أسماء مطبوعة: | Publication: 2012-: Oxford, England : Oxford University Press Original Publication: [Berlin] : Springer International ; [Secaucus, NJ, USA : Springer-Verlag New York Inc., distributor, c1987- |
مواضيع طبية MeSH: | Aortic Valve Insufficiency*/surgery, Aorta ; Aortic Valve/surgery ; Humans ; Male ; Middle Aged ; Reoperation ; Replantation ; Retrospective Studies ; Treatment Outcome |
مستخلص: | Objectives: The aim of this study was to evaluate whether additional cusp interventions and valve types affect aortic valve-related reoperation and mortality rates after the David procedure. Methods: Between 1997 and 2018, a total of 449 patients {372 males; mean age 54.2 [standard deviation (SD) 15.2] years, range: 12.7-79.9 years} underwent elective valve-sparing aortic root replacement (David procedure) for aortic regurgitation and were prospectively followed up clinically and echocardiographically. Results: The follow-up was 94% complete. Cumulative follow-up time was 2268 patient-years [mean follow-up time 5.1 (4.3 SD) years]. Thirty-day mortality was 2.2% (n = 10). Late (>30 days) survival did not differ from that of the age- and gender-matched general population. Freedom from reoperation in patients without additional cusp reconstruction was 94% [95% confidence interval (CI) 91-98] and 92% (95% CI 88-97) at 5 and 10 years, respectively, which was not significantly different (P = 1) for patients who did require additional cusp reconstruction 98% (95% CI 95-100) and 89% (95% CI 81-99). In patients with tricuspid aortic valves (n = 338), freedom from reoperation was 96% (95% CI 94-99) and 93% (95% CI 88-97) at 5 and 10 years, respectively. Patients with bicuspid aortic valves (n = 111) had a freedom from reoperation of 94% (95% CI 89-99) at 5 years and 88% (95% CI 79-98) at 10 years (P = 0.021 for the comparison to tricuspid aortic valve). Overall, 23 patients (5%; 1%/patient-year) required reoperation with a mean interval of 4.5 (4.8 SD) months. Conclusions: The David procedure revealed low mid-term reoperation risk and excellent survival independent of adjunctive cusp interventions/valve morphology and is comparable with that of the age- and gender-matched general population. (© The Author(s) 2020. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.) |
فهرسة مساهمة: | Keywords: Bicuspid and tricuspid aortic valve; Cusp reconstruction; David procedure |
تواريخ الأحداث: | Date Created: 20200515 Date Completed: 20210621 Latest Revision: 20210621 |
رمز التحديث: | 20231215 |
DOI: | 10.1093/ejcts/ezaa149 |
PMID: | 32408342 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1873-734X |
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DOI: | 10.1093/ejcts/ezaa149 |