university of lübeck department of cardiac and thoracic vascular surgery diagnostics in pre and...
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University of Lübeck
Department of Cardiac and Thoracic Vascular Surgery
Diagnostics in pre and post-op managment in
AF patiens
Thorsten Hanke
University of Lübeck
Department of Cardiac and Thoracic Vascular Surgery
University of Lübeck
Department of Cardiac and Thoracic Vascular Surgery
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Thorsten Hanke:
“Does type of aortic root repair in acute type A dissection matter? A comparison between valve sparing procedures and the “gold standard””
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University of Lübeck
Department of Cardiac and Thoracic Vascular Surgery
Does type of aortic root repair in acute type A dissection matter? A comparison between valve sparing procedures and the “gold standard
Thorsten Hanke, Holger Sier, Efstratios I. Charitos, Ulrich Stierle, Hans-H. Sievers
University of Lübeck
Department of Cardiac and Thoracic Vascular Surgery
Methods:
All operations for type A aortic dissection performed since 1993 were identified and follow up information was gathered by contacting the patient and/or his/her physician.
Results were compared using Kaplan-Meier curves.
Utilizing complex surgical aortic root procedures in acute type A aortic dissection is still a matter of debate.
We reviewed the midterm results in our institution.
University of Lübeck
Department of Cardiac and Thoracic Vascular Surgery
Techniques
86 operations were performed:
37 valve reimplantation procedures (David, 38%)
29 valve remodeling procedures (Yacoub, 30%)
27 valve / ascending aortic conduits (Bentall, 31%)
University of Lübeck
Department of Cardiac and Thoracic Vascular Surgery
Survival (Kaplan-Meier)
Bentall
David
Yacoub
p=0.755
University of Lübeck
Department of Cardiac and Thoracic Vascular Surgery
Results
In hospital mortality:
18,5 % in the Bentall group
13,5 % in the David group and
6,9 % in the Yacoub group
University of Lübeck
Department of Cardiac and Thoracic Vascular Surgery
Results
Probability of survival and freedom from aortic reoperation at ten years was:
58 % in the Bentall group
53 % in the David group and
45 % in the Yacoub group
University of Lübeck
Department of Cardiac and Thoracic Vascular Surgery
Results
Probability of survival and freedom from aortic reoperation at ten years was:
58 % in the Bentall group
54 % in the David group and
45 % in the Yacoub group
No difference according to the
type of surgery performed
(p=0.755)
University of Lübeck
Department of Cardiac and Thoracic Vascular Surgery
Conclusion
When tailored to the specific pathology, aortic valve sparing
procedures in comparison to the gold standard Bentall procedure
for treatment of the aortic root in type A aortic dissections yield
satisfying midterm results regarding survival and freedom of
reoperation.
University of Lübeck
Department of Cardiac and Thoracic Vascular Surgery
Thank You!