Remodeling root repair with an external aortic ring annuloplasty

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11150%2F17%3A10368318" target="_blank" >RIV/00216208:11150/17:10368318 - isvavai.cz</a>

Alternative codes found

RIV/00179906:_____/17:10368318

Result on the web

<a href="http://dx.doi.org/10.1016/j.jtcvs.2016.12.031" target="_blank" >http://dx.doi.org/10.1016/j.jtcvs.2016.12.031</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1016/j.jtcvs.2016.12.031" target="_blank" >10.1016/j.jtcvs.2016.12.031</a>

Result language

angličtina

Original language name

Remodeling root repair with an external aortic ring annuloplasty

Original language description

Objective: Although the remodeling technique provides the most dynamic valve-sparing root replacement, a dilated annulus (&gt; 25 mm) is a risk factor for failure. Aortic annuloplasty aims to reduce the annulus diameter, thus increasing coaptation height to protect the repair. The results of 177 patients with remodeling and external aortic ring annuloplasty were studied. Methods: Data were collected from the Aortic Valve repair InternATiOnal Registry. Preoperative aortic insufficiency grade 3 or greater was present in 79 patients (44.7%). The valve was bicuspid in 59 patients (33.3%). External annuloplasty was performed through a homemade Dacron ring (56) or a dedicated expansible aortic ring (121). Results: Thirty-day mortality was 2.9% (5). Mean follow-up was 41.1 +/- 36.4 months. For the whole series, freedom from valve-related reoperation, aortic insufficiency grade 3 or greater, aortic insufficiency grade 2 or greater, and major adverse valve-related events were 89.5%, 90.5%, 77.4%, and 86.6% at 7 years, respectively, with similar results for tricuspid and bicuspid valves. Since 2007, systematic use of calibrated expansible ring annuloplasty, followed 1 year later by systematic cusp effective height assessment, significantly increased 7-year freedom from valve-related reoperation, aortic insufficiency grade 3 or greater, and major adverse valve-related events up to 99.1% +/- 0.9% (P = .017), 100% (P = .026), and 96.3% +/- 1.8% (P = .035), respectively, whereas freedom from aortic insufficiency grade 2 or greater remained unaffected (78.1% +/- 7.6%). Calibrated annuloplasty and effective height assessment were identified as protective factors from reoperation: hazard ratio, 0.13; 95% confidence interval, 0.02-1.06; P = .057 and hazard ratio, 0.11; 95% confidence interval, 0.01-0.95; P = .044, respectively. Conclusions: The standardization of remodeling root repair with calibrated expansible aortic ring annuloplasty and cusp effective height assessment improves valve repair outcomes.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

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OECD FORD branch

30201 - Cardiac and Cardiovascular systems

Project

—

Continuities

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Publication year

2017

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

The Journal of Thoracic and Cardiovascular Surgery

ISSN

0022-5223

e-ISSN

—

Volume of the periodical

153

Issue of the periodical within the volume

5

Country of publishing house

US - UNITED STATES

Number of pages

10

Pages from-to

1033-1042

UT code for WoS article

000402474500015

EID of the result in the Scopus database

2-s2.0-85011573451