One-year appraisal of a new aortic root conduit with sinuses of Valsalva
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- 作者：Ruggero De Paulis ; Giovanni Maria De Matteis ; Paolo Nardi ; Raffaele Scaffa ; Dionisio F. Colella ; Carlo Bassano ; Fabrizio Tomai ; Luigi Chiariello
- 关键词：16 ; 17
- 刊名：The Journal of Thoracic and Cardiovascular Surgery
- 出版年：2002
- 出版时间：January 2002
- 年：2002
- 卷：123
- 期：1
- 页码：33-39
- 全文大小：177 K
文摘
Objectives: We evaluate the clinical results 1 year after an anatomic reconstruction of the aortic root in which we used a specifically designed aortic root prosthesis that incorporates the sinuses of Valsalva. Material and Methods: The new aortic Dacron prosthesis has a proximal portion in the Dacron conduit that expands on implantation, creating pseudosinuses. During a 12-month period, 28 patients (mean age 59 ± 14 years) underwent a Bentall operation (12 cases), a remodeling procedure (7 cases), and a reimplantation procedure (9 cases) with the use of a new aortic root conduit. All patients had aortic root aneurysm with an anatomically normal (for the valve-sparing procedure) or diseased aortic valve (for the Bentall operation). Five patients had aortic dissection and 5 had Marfan disease. The mean follow-up was 6 ± 3 months. All patients underwent postoperative transesophageal and transthoracic echocardiographic studies. Results: All patients survived and were in good clinical condition at the latest follow-up. Postoperative echocardiography showed a marked reduction in ventricular volumes in all patient groups (P < .0005). In the Bentall group the new prosthesis appeared to reduce the tension on the coronary ostial sutures. In patients undergoing both types of valve-sparing procedures a similar normal anatomy of the aortic root was reconstructed. In the reimplantation group the anulus was smaller than in the remodeling group (P = .01). Patients undergoing the reimplantation procedure had less bleeding and a lower incidence of residual valve insufficiency. Conclusions: The new aortic root prosthesis allowed the reconstruction of the aortic root anatomy in all types of surgical techniques with low postoperative morbidity.