University of Lübeck Department of Cardiac and Thoracic Vascular Surgery

Diagnostics in pre and post-op managment in

AF patiensThorsten 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 groupNo 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!