Management of aortic root in type A dissection: Bentall approach. Issue 5 (20th December 2020)
- Record Type:
- Journal Article
- Title:
- Management of aortic root in type A dissection: Bentall approach. Issue 5 (20th December 2020)
- Main Title:
- Management of aortic root in type A dissection: Bentall approach
- Authors:
- Khachatryan, Zara
Leontyev, Sergey
Magomedov, Khadzhimurad
Haunschild, Josephina
Holzhey, David M.
Misfeld, Martin
Etz, Christian D.
Borger, Michael A. - Other Names:
- Bashir Mohamad guestEditor.
Bavaria Joseph guestEditor.
Elefteriades John guestEditor.
Chen Ed guestEditor. - Abstract:
- Abstract: Background: We analyzed the results of the modified Bentall procedure in a high‐risk group of patients presenting with acute type A aortic dissection (ATAAD). Methods: ATAAD patients undergoing a modified Bentall between 1996 and 2018 ( n = 314) were analyzed. Mechanical composite conduits were used in 45%, and biological ones using either a bioprosthesis implanted into an aortic graft (33%) or xeno‐/homograft root conduits (22%) in the rest. Preoperative malperfusion was present in 34% of patients and cardiopulmonary resuscitation required in 9%. Results: Concomitant arch procedures consisted of hemiarch in 56% and total arch/elephant trunk in 34%, while concomitant coronary artery surgery was required in 20%. The average cross‐clamp and cardiopulmonary bypass times were 126 ± 43 and 210 ± 76 min, respectively, while the average circulatory arrest times were 29 ± 17 min. A total of 69 patients (22%) suffered permanent neurologic deficit, while myocardial infarction occurred in 18 cases (6%) and low cardiac output syndrome in 47 (15%). The in‐hospital mortality rate was 17% due to intractable low cardiac output syndrome ( n = 29), major brain injury ( n = 16), multiorgan failure ( n = 6), and sepsis ( n = 2). The independent predictors of in‐hospital mortality were critical preoperative state (odds ratio [OR], 5.6; p < .001), coronary malperfusion (OR, 3.6; p = .002), coronary artery disease (OR, 2.6; p = .033), and prior cerebrovascular accident (OR, 5.6;Abstract: Background: We analyzed the results of the modified Bentall procedure in a high‐risk group of patients presenting with acute type A aortic dissection (ATAAD). Methods: ATAAD patients undergoing a modified Bentall between 1996 and 2018 ( n = 314) were analyzed. Mechanical composite conduits were used in 45%, and biological ones using either a bioprosthesis implanted into an aortic graft (33%) or xeno‐/homograft root conduits (22%) in the rest. Preoperative malperfusion was present in 34% of patients and cardiopulmonary resuscitation required in 9%. Results: Concomitant arch procedures consisted of hemiarch in 56% and total arch/elephant trunk in 34%, while concomitant coronary artery surgery was required in 20%. The average cross‐clamp and cardiopulmonary bypass times were 126 ± 43 and 210 ± 76 min, respectively, while the average circulatory arrest times were 29 ± 17 min. A total of 69 patients (22%) suffered permanent neurologic deficit, while myocardial infarction occurred in 18 cases (6%) and low cardiac output syndrome in 47 (15%). The in‐hospital mortality rate was 17% due to intractable low cardiac output syndrome ( n = 29), major brain injury ( n = 16), multiorgan failure ( n = 6), and sepsis ( n = 2). The independent predictors of in‐hospital mortality were critical preoperative state (odds ratio [OR], 5.6; p < .001), coronary malperfusion (OR, 3.6; p = .002), coronary artery disease (OR, 2.6; p = .033), and prior cerebrovascular accident (OR, 5.6; p = .002). Conclusions: The modified Bentall operation, along with necessary concomitant procedures, can be performed with good early results in high‐risk ATAAD patients presenting. … (more)
- Is Part Of:
- Journal of cardiac surgery. Volume 36:Issue 5(2021)
- Journal:
- Journal of cardiac surgery
- Issue:
- Volume 36:Issue 5(2021)
- Issue Display:
- Volume 36, Issue 5 (2021)
- Year:
- 2021
- Volume:
- 36
- Issue:
- 5
- Issue Sort Value:
- 2021-0036-0005-0000
- Page Start:
- 1779
- Page End:
- 1785
- Publication Date:
- 2020-12-20
- Subjects:
- aorta and great vessels -- aortic dissection -- Bentall
Heart -- Surgery -- Periodicals
617.412005 - Journal URLs:
- http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1540-8191 ↗
http://www.blackwell-synergy.com/rd.asp?goto=journal&code=jcs ↗
http://onlinelibrary.wiley.com/ ↗
http://firstsearch.oclc.org ↗ - DOI:
- 10.1111/jocs.15271 ↗
- Languages:
- English
- ISSNs:
- 0886-0440
- Deposit Type:
- Legaldeposit
- View Content:
- Available online (eLD content is only available in our Reading Rooms) ↗
- Physical Locations:
- British Library DSC - 4954.863500
British Library DSC - BLDSS-3PM
British Library HMNTS - ELD Digital store - Ingest File:
- 22901.xml