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• W4312542911 abstract "Composite graft replacement is an established surgical procedure that radically treats pathologies of the aortic root, especially when the aortic valve cannot be spared. We analysed the intraoperative details and the short-term outcome of a large consecutive series of patients operated on in a teaching tertiary institution.Out of 877 patients who received a composite graft during a 13-year period, we excluded all those who were operated on as an emergency because of a type A acute aortic dissection, those who underwent this procedure as a redo surgery and those who presented with a destructive endocarditis of the aortic root. Finally 622 patients with a mean age of 59.5 ± 12.5 years (range 16–85) were analysed. Of these, 423 patients (68%) were male, and the mean body mass index was 27.8 ± 4.3 kg/m2 (18.4–37.3). Annulo-aortic dilatation with or without aortic valve dysfunction was the most frequent indication (n = 448), bicuspid valve with aortic root and/or ascending aortic dilatation was found in 107 patients and typical aortic root dilatation in the presence of Marfan/Loeys-Dietz syndrome was found in 33 patients. A large majority of patients presented with moderate or severe aortic regurgitation (n = 409, 65%), and aortic stenosis was present in 164 patients (26.5%).Early mortality occurred in nine patients (1.4%). Causes of death were: low output syndrome in three patients, severe cerebrovascular complications in four and respiratory or multiorgan failure in one patient each. Multivariate logistic regression analysis showed that severely reduced left ventricular function (left ventricular ejection fraction [LVEF] <0.35) (odds ratio [OR] 4.9, 95% confidence interval [CI] 1.7–12.2), aortic regurgitation grade IV (OR 6.35, 95% CI 1.8–17.8), new York Heart Association functional class III or IV (OR 2.94, 95% CI 1.5–7.4) and need for additional coronary artery bypass graft surgery (OR 4.25, 95% CI 1.6–11.3) were the independent risk factors for mortality as well as for early morbidity.Composite graft replacement is a standard procedure to treat different pathologies of the aortic root and is associated with a low perioperative risk. This justifies liberal indications in the case of a moderately dilated aortic root (4.5–5 cm) in younger patients (<60 years) and in those with a particular cardiovascular risk profile." @default.
• W4312542911 created "2023-01-05" @default.
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• W4312542911 date "2021-07-01" @default.
• W4312542911 modified "2023-09-26" @default.
• W4312542911 title "Composite graft replacement of the aortic root: experience in a tertiary care teaching institution" @default.
• W4312542911 doi "https://doi.org/10.4414/cvm.2021.02172" @default.
• W4312542911 hasPublicationYear "2021" @default.
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