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Early results of valve sparing aortic root reconstruction in acute Stanford type A aortic dissection Mina Wahba, Said Soliman, Omar Dawoud, Alaaeldin.

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Presentation on theme: "Early results of valve sparing aortic root reconstruction in acute Stanford type A aortic dissection Mina Wahba, Said Soliman, Omar Dawoud, Alaaeldin."— Presentation transcript:

1 Early results of valve sparing aortic root reconstruction in acute Stanford type A aortic dissection
Mina Wahba, Said Soliman, Omar Dawoud, Alaaeldin Mohamed, Ahmed Daoud, Waleed Hussein.   Cardiothoracic Surgery department, Faculty of Medicine, Benisuef university Cardiothoracic Surgery department, Faculty of Medicine, Cairo university 

2 OBJECTIVE The aim of this study is to evaluate the early mortality and morbidities in acute ascending aortic dissection patients treated by aortic root reconstruction techniques.

3 METHODS This is a retrospective and prospective non randomized study including 30 patients in which aortic valve sparing and root reconstruction was done.

4 METHODS INCLUSION CRITERIA: - Acute Stanford type A aortic dissection
- Left ventricular EF above 30% EXCLUSION CRITERIA: - Redo patients - Stanford type B aortic dissection - Patients undergoing replacement of ascending aorta plus other cardiac surgeries. - Patients with rheumatic aortic valve diseases.

5 RESULTS Mean age: 53±12 years Gender distribution: 21 males (70%)
9 females (30%)

6 RESULTS Aortic valve re-implantation: 19 patients

7 RESULTS One or two sinus replacement plus supra- commisuralconduit:
10 patients Remodelling technique: 1 patient

8 RESULTS Early mortality 6 (20%) Neurological complications 7(25%)
Renal complications 10 (35.7%) Respiratory complications 5 (17.9%) Re-opening for bleeding

9 RESULTS Early mortality : 2 intra-operative mortalities, due to myocardial failure and massive uncontrollable bleeding. The other 4 patients died during the first 48 hours in I.C.U, 3 of them because of myocardial failure and one because of respiratory failure. Neurological complications : delayed recovery more than 24 hours in 4 patients and 3 patients with cerebro-vascular stroke one of which suffered permanent hemiplegia .  Renal complications : Ten patients had renal impairment in the form of elevated creatinine, 3 of them needed one or two sessions of dialysis and resolved completely and only one patient became in need for regular dialysis .

10 RESULTS Post-operative echocardiography Aortic regurge Nil : 21 (75%)
Trivial: 4 (14.3%) Mild: 3 (10.7%) Moderate: 0 Severe: 0

11 CONCLUSION: Our early results show excellent valvular stability without an increased operative risk. Freedom from anticoagulation and complete resection of diseased tissue represent unquestionable advantages of these techniques. 

12 THANK YOU


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