Aortic Valve-Sparing Root Replacement (David I Procedure) in Adolescents: Long-Term Outcome.
Thorac Cardiovasc Surg
; 69(4): 308-313, 2021 06.
Article
in En
| MEDLINE
| ID: mdl-31330554
ABSTRACT
INTRODUCTION:
Aortic valve-sparing root replacement (David's procedure) is an especially appealing treatment option for young patients. Here, we present the short-, mid, and long-term outcomes of this operation in adolescent patients.METHODS:
Between September 1994 and March 2014, 29 patients aged 6 to 21 years underwent the David-I procedure at our center. We conducted a retrospective study with follow-up.RESULTS:
The mean age was 16.8 ± 3.4 years and 90% (n = 26) were male. Marfan's syndrome was present in 86% (n = 25) of cases. Ninety-seven percent (n = 28) of cases were performed electively, and one case (3%) was performed emergently for acute aortic dissection type A. There were no early perioperative deaths (0%). Follow-up, which was completed on 100% of patients, comprised a total of 394 patient years and a mean follow-up time of 13.6 ± 5.4 years. The estimates for survival at 1, 5, and 10 years after initial surgery were 100, 97, and 93%, respectively. During follow-up, there were four (14%) late deaths and five (17%) aortic valve-related reoperations. The 1-, 5-, and 10-year estimates for freedom from valve-related reoperation were 100, 86, and 83%, respectively. The perioperative mortality for these five reoperations was 0%.DISCUSSION:
Aortic valve-sparing root replacement can be performed in adolescents with a very low perioperative risk. Long-term survival seems to be affected by connective tissue diseases.
Full text:
1
Database:
MEDLINE
Main subject:
Aortic Aneurysm
/
Aortic Valve
/
Replantation
/
Blood Vessel Prosthesis Implantation
/
Aortic Dissection
Type of study:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limits:
Adolescent
/
Adult
/
Child
/
Female
/
Humans
/
Male
Language:
En
Year:
2021
Type:
Article