Reoperation after aortic root replacement and its impact on long-term survival
Reoperation after aortic root replacement (ARR) is associated with increased operative risk and complexity. This study evaluated clinical outcomes and reoperation rates in patients undergoing ARR. From 2004 to 2021, 2700 adult patients underwent an ARR in a 2-institution database. Among 2542 survivi...
Gespeichert in:
| Veröffentlicht in: | JTCVS open 2024-10, Vol.21, p.45-57 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 57 |
|---|---|
| container_issue | |
| container_start_page | 45 |
| container_title | JTCVS open |
| container_volume | 21 |
| creator | Norton, Elizabeth L. Patel, Parth M. Wang, Yanhua Binongo, Jose Levine, Dov Singh, Sameer Chodisetty, Shreya Olakunle, Oreoluwa E. Leshnower, Bradley G. Takayama, Hiroo Chen, Edward P. |
| description | Reoperation after aortic root replacement (ARR) is associated with increased operative risk and complexity. This study evaluated clinical outcomes and reoperation rates in patients undergoing ARR.
From 2004 to 2021, 2700 adult patients underwent an ARR in a 2-institution database. Among 2542 surviving patients, 705 patients who had a history of previous cardiac surgery as well as 11 patients who underwent transcatheter aortic valve replacement after index ARR were excluded. Among the finalized cohort of 1826 patients, 88 (4.8%) underwent a reoperation (REDO) on the aortic valve or proximal aorta (root/ascending) a mean of 3.1 years after index ARR whereas 1738 (95%) did not undergo reoperation (no-REDO). A subgroup analysis was performed among those undergoing reoperation by indication including valve dysfunction (48%), endocarditis/graft infection (33%), and aortic aneurysm/dissection/rupture (12%). Reoperative indication was unknown in 6 patients (7%).
The REDO group was younger at time of index ARR (52 vs 58 years, P |
| doi_str_mv | 10.1016/j.xjon.2024.05.003 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_11551283</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S2666273624001232</els_id><sourcerecordid>3128816100</sourcerecordid><originalsourceid>FETCH-LOGICAL-c337t-2231b23963a14d55d82df1a0c501194af2fb54ca19f2450906d62af90b37ccaa3</originalsourceid><addsrcrecordid>eNp9kUtrGzEUhUVpqI3jP9BF0DKbmeoxkj0QKCGkDzAJhHQtrjV3XJmZ0VSSTfPvI2M3OJuihQT6zrmXcwj5zFnJGddftuXfrR9KwURVMlUyJj-QqdBaF2Ih9cez94TMY9wyxoTiUqnlJzKRtZJVPlPy8IR-xADJ-YFCmzBQ8CE5S4P3iQYcO7DY45AoDA11KVLXj2ATzXznh02RJT2Nu7B3e-guyUULXcT56Z6RX9_un-9-FKvH7z_vbleFlXKRCiEkXwtZawm8apRqlqJpOTCrGOd1Ba1o16qywOtWVIrVTDdaQFuztVxYCyBn5OvRd9yte2xs3i9AZ8bgeggvxoMz738G99ts_N5wrhQXS5kdrk8Owf_ZYUymd9Fi18GAfheNzNSSa56DnRFxRG3wMQZs3-ZwZg5lmK05lGEOZRimTNZk0dX5hm-Sf9Fn4OYIYM5p7zCYaB0OFhsX0CbTePc__1cbKpxJ</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3128816100</pqid></control><display><type>article</type><title>Reoperation after aortic root replacement and its impact on long-term survival</title><source>DOAJ Directory of Open Access Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central</source><source>Alma/SFX Local Collection</source><creator>Norton, Elizabeth L. ; Patel, Parth M. ; Wang, Yanhua ; Binongo, Jose ; Levine, Dov ; Singh, Sameer ; Chodisetty, Shreya ; Olakunle, Oreoluwa E. ; Leshnower, Bradley G. ; Takayama, Hiroo ; Chen, Edward P.</creator><creatorcontrib>Norton, Elizabeth L. ; Patel, Parth M. ; Wang, Yanhua ; Binongo, Jose ; Levine, Dov ; Singh, Sameer ; Chodisetty, Shreya ; Olakunle, Oreoluwa E. ; Leshnower, Bradley G. ; Takayama, Hiroo ; Chen, Edward P.</creatorcontrib><description>Reoperation after aortic root replacement (ARR) is associated with increased operative risk and complexity. This study evaluated clinical outcomes and reoperation rates in patients undergoing ARR.
From 2004 to 2021, 2700 adult patients underwent an ARR in a 2-institution database. Among 2542 surviving patients, 705 patients who had a history of previous cardiac surgery as well as 11 patients who underwent transcatheter aortic valve replacement after index ARR were excluded. Among the finalized cohort of 1826 patients, 88 (4.8%) underwent a reoperation (REDO) on the aortic valve or proximal aorta (root/ascending) a mean of 3.1 years after index ARR whereas 1738 (95%) did not undergo reoperation (no-REDO). A subgroup analysis was performed among those undergoing reoperation by indication including valve dysfunction (48%), endocarditis/graft infection (33%), and aortic aneurysm/dissection/rupture (12%). Reoperative indication was unknown in 6 patients (7%).
The REDO group was younger at time of index ARR (52 vs 58 years, P < .0001) and had more bicuspid aortic valves (56% vs 37%, P = .0003). Most patients underwent modified Bentall ARR (61%), whereas 38% underwent a valve-sparing root replacement. Index root operations were similar between groups. At time of reoperation, 53% underwent aortic valve replacement and 35% underwent redo root replacement. Long-term survival was similar between REDO and no-REDO groups (80% vs 85%, P = .26) and reoperation was not a risk factor for late mortality (hazard ratio, 1.31; P = .26); however, REDO ARR was a risk factor for late mortality (hazard ratio, 2.41; P = .02).
The incidence of aortic valve and/or proximal aorta reoperation after index ARR is relatively low at 4.8%; however, root reoperation is a risk factor for late mortality.
[Display omitted]</description><identifier>ISSN: 2666-2736</identifier><identifier>EISSN: 2666-2736</identifier><identifier>DOI: 10.1016/j.xjon.2024.05.003</identifier><identifier>PMID: 39534343</identifier><language>eng</language><publisher>Netherlands: Elsevier Inc</publisher><subject>Adult: Aorta ; aorta ; aortic dissection ; aortic root replacement ; endocarditis ; redo-root replacement ; reoperation ; valve-sparing aortic root replacement</subject><ispartof>JTCVS open, 2024-10, Vol.21, p.45-57</ispartof><rights>2024 The Author(s)</rights><rights>2024 The Author(s).</rights><rights>2024 The Author(s) 2024</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c337t-2231b23963a14d55d82df1a0c501194af2fb54ca19f2450906d62af90b37ccaa3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11551283/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11551283/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39534343$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Norton, Elizabeth L.</creatorcontrib><creatorcontrib>Patel, Parth M.</creatorcontrib><creatorcontrib>Wang, Yanhua</creatorcontrib><creatorcontrib>Binongo, Jose</creatorcontrib><creatorcontrib>Levine, Dov</creatorcontrib><creatorcontrib>Singh, Sameer</creatorcontrib><creatorcontrib>Chodisetty, Shreya</creatorcontrib><creatorcontrib>Olakunle, Oreoluwa E.</creatorcontrib><creatorcontrib>Leshnower, Bradley G.</creatorcontrib><creatorcontrib>Takayama, Hiroo</creatorcontrib><creatorcontrib>Chen, Edward P.</creatorcontrib><title>Reoperation after aortic root replacement and its impact on long-term survival</title><title>JTCVS open</title><addtitle>JTCVS Open</addtitle><description>Reoperation after aortic root replacement (ARR) is associated with increased operative risk and complexity. This study evaluated clinical outcomes and reoperation rates in patients undergoing ARR.
From 2004 to 2021, 2700 adult patients underwent an ARR in a 2-institution database. Among 2542 surviving patients, 705 patients who had a history of previous cardiac surgery as well as 11 patients who underwent transcatheter aortic valve replacement after index ARR were excluded. Among the finalized cohort of 1826 patients, 88 (4.8%) underwent a reoperation (REDO) on the aortic valve or proximal aorta (root/ascending) a mean of 3.1 years after index ARR whereas 1738 (95%) did not undergo reoperation (no-REDO). A subgroup analysis was performed among those undergoing reoperation by indication including valve dysfunction (48%), endocarditis/graft infection (33%), and aortic aneurysm/dissection/rupture (12%). Reoperative indication was unknown in 6 patients (7%).
The REDO group was younger at time of index ARR (52 vs 58 years, P < .0001) and had more bicuspid aortic valves (56% vs 37%, P = .0003). Most patients underwent modified Bentall ARR (61%), whereas 38% underwent a valve-sparing root replacement. Index root operations were similar between groups. At time of reoperation, 53% underwent aortic valve replacement and 35% underwent redo root replacement. Long-term survival was similar between REDO and no-REDO groups (80% vs 85%, P = .26) and reoperation was not a risk factor for late mortality (hazard ratio, 1.31; P = .26); however, REDO ARR was a risk factor for late mortality (hazard ratio, 2.41; P = .02).
The incidence of aortic valve and/or proximal aorta reoperation after index ARR is relatively low at 4.8%; however, root reoperation is a risk factor for late mortality.
[Display omitted]</description><subject>Adult: Aorta</subject><subject>aorta</subject><subject>aortic dissection</subject><subject>aortic root replacement</subject><subject>endocarditis</subject><subject>redo-root replacement</subject><subject>reoperation</subject><subject>valve-sparing aortic root replacement</subject><issn>2666-2736</issn><issn>2666-2736</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9kUtrGzEUhUVpqI3jP9BF0DKbmeoxkj0QKCGkDzAJhHQtrjV3XJmZ0VSSTfPvI2M3OJuihQT6zrmXcwj5zFnJGddftuXfrR9KwURVMlUyJj-QqdBaF2Ih9cez94TMY9wyxoTiUqnlJzKRtZJVPlPy8IR-xADJ-YFCmzBQ8CE5S4P3iQYcO7DY45AoDA11KVLXj2ATzXznh02RJT2Nu7B3e-guyUULXcT56Z6RX9_un-9-FKvH7z_vbleFlXKRCiEkXwtZawm8apRqlqJpOTCrGOd1Ba1o16qywOtWVIrVTDdaQFuztVxYCyBn5OvRd9yte2xs3i9AZ8bgeggvxoMz738G99ts_N5wrhQXS5kdrk8Owf_ZYUymd9Fi18GAfheNzNSSa56DnRFxRG3wMQZs3-ZwZg5lmK05lGEOZRimTNZk0dX5hm-Sf9Fn4OYIYM5p7zCYaB0OFhsX0CbTePc__1cbKpxJ</recordid><startdate>20241001</startdate><enddate>20241001</enddate><creator>Norton, Elizabeth L.</creator><creator>Patel, Parth M.</creator><creator>Wang, Yanhua</creator><creator>Binongo, Jose</creator><creator>Levine, Dov</creator><creator>Singh, Sameer</creator><creator>Chodisetty, Shreya</creator><creator>Olakunle, Oreoluwa E.</creator><creator>Leshnower, Bradley G.</creator><creator>Takayama, Hiroo</creator><creator>Chen, Edward P.</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>6I.</scope><scope>AAFTH</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20241001</creationdate><title>Reoperation after aortic root replacement and its impact on long-term survival</title><author>Norton, Elizabeth L. ; Patel, Parth M. ; Wang, Yanhua ; Binongo, Jose ; Levine, Dov ; Singh, Sameer ; Chodisetty, Shreya ; Olakunle, Oreoluwa E. ; Leshnower, Bradley G. ; Takayama, Hiroo ; Chen, Edward P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c337t-2231b23963a14d55d82df1a0c501194af2fb54ca19f2450906d62af90b37ccaa3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adult: Aorta</topic><topic>aorta</topic><topic>aortic dissection</topic><topic>aortic root replacement</topic><topic>endocarditis</topic><topic>redo-root replacement</topic><topic>reoperation</topic><topic>valve-sparing aortic root replacement</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Norton, Elizabeth L.</creatorcontrib><creatorcontrib>Patel, Parth M.</creatorcontrib><creatorcontrib>Wang, Yanhua</creatorcontrib><creatorcontrib>Binongo, Jose</creatorcontrib><creatorcontrib>Levine, Dov</creatorcontrib><creatorcontrib>Singh, Sameer</creatorcontrib><creatorcontrib>Chodisetty, Shreya</creatorcontrib><creatorcontrib>Olakunle, Oreoluwa E.</creatorcontrib><creatorcontrib>Leshnower, Bradley G.</creatorcontrib><creatorcontrib>Takayama, Hiroo</creatorcontrib><creatorcontrib>Chen, Edward P.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>JTCVS open</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Norton, Elizabeth L.</au><au>Patel, Parth M.</au><au>Wang, Yanhua</au><au>Binongo, Jose</au><au>Levine, Dov</au><au>Singh, Sameer</au><au>Chodisetty, Shreya</au><au>Olakunle, Oreoluwa E.</au><au>Leshnower, Bradley G.</au><au>Takayama, Hiroo</au><au>Chen, Edward P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Reoperation after aortic root replacement and its impact on long-term survival</atitle><jtitle>JTCVS open</jtitle><addtitle>JTCVS Open</addtitle><date>2024-10-01</date><risdate>2024</risdate><volume>21</volume><spage>45</spage><epage>57</epage><pages>45-57</pages><issn>2666-2736</issn><eissn>2666-2736</eissn><abstract>Reoperation after aortic root replacement (ARR) is associated with increased operative risk and complexity. This study evaluated clinical outcomes and reoperation rates in patients undergoing ARR.
From 2004 to 2021, 2700 adult patients underwent an ARR in a 2-institution database. Among 2542 surviving patients, 705 patients who had a history of previous cardiac surgery as well as 11 patients who underwent transcatheter aortic valve replacement after index ARR were excluded. Among the finalized cohort of 1826 patients, 88 (4.8%) underwent a reoperation (REDO) on the aortic valve or proximal aorta (root/ascending) a mean of 3.1 years after index ARR whereas 1738 (95%) did not undergo reoperation (no-REDO). A subgroup analysis was performed among those undergoing reoperation by indication including valve dysfunction (48%), endocarditis/graft infection (33%), and aortic aneurysm/dissection/rupture (12%). Reoperative indication was unknown in 6 patients (7%).
The REDO group was younger at time of index ARR (52 vs 58 years, P < .0001) and had more bicuspid aortic valves (56% vs 37%, P = .0003). Most patients underwent modified Bentall ARR (61%), whereas 38% underwent a valve-sparing root replacement. Index root operations were similar between groups. At time of reoperation, 53% underwent aortic valve replacement and 35% underwent redo root replacement. Long-term survival was similar between REDO and no-REDO groups (80% vs 85%, P = .26) and reoperation was not a risk factor for late mortality (hazard ratio, 1.31; P = .26); however, REDO ARR was a risk factor for late mortality (hazard ratio, 2.41; P = .02).
The incidence of aortic valve and/or proximal aorta reoperation after index ARR is relatively low at 4.8%; however, root reoperation is a risk factor for late mortality.
[Display omitted]</abstract><cop>Netherlands</cop><pub>Elsevier Inc</pub><pmid>39534343</pmid><doi>10.1016/j.xjon.2024.05.003</doi><tpages>13</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 2666-2736 |
| ispartof | JTCVS open, 2024-10, Vol.21, p.45-57 |
| issn | 2666-2736 2666-2736 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_11551283 |
| source | DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Alma/SFX Local Collection |
| subjects | Adult: Aorta aorta aortic dissection aortic root replacement endocarditis redo-root replacement reoperation valve-sparing aortic root replacement |
| title | Reoperation after aortic root replacement and its impact on long-term survival |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-26T18%3A20%3A00IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Reoperation%20after%20aortic%20root%20replacement%20and%20its%20impact%20on%20long-term%20survival&rft.jtitle=JTCVS%20open&rft.au=Norton,%20Elizabeth%20L.&rft.date=2024-10-01&rft.volume=21&rft.spage=45&rft.epage=57&rft.pages=45-57&rft.issn=2666-2736&rft.eissn=2666-2736&rft_id=info:doi/10.1016/j.xjon.2024.05.003&rft_dat=%3Cproquest_pubme%3E3128816100%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=3128816100&rft_id=info:pmid/39534343&rft_els_id=S2666273624001232&rfr_iscdi=true |