Embolic and bleeding events after modified Bentall procedure in selected patients.

Details

Serval ID
serval:BIB_189B4D70DC05
Type
Article: article from journal or magazin.
Collection
Publications
Title
Embolic and bleeding events after modified Bentall procedure in selected patients.
Journal
Heart
Author(s)
Radu N.C., Kirsch M., Hillion M.L., Lagneau F., Drouet L., Loisance D.
ISSN
1468-201X (Electronic)
ISSN-L
1355-6037
Publication state
Published
Issued date
01/2007
Peer-reviewed
Oui
Volume
93
Number
1
Pages
107-112
Language
english
Notes
Publication types: Evaluation Studies ; Journal Article
Publication Status: ppublish
Abstract
As valve-sparing procedures gain increasing popularity, the long-term results of the total aortic root replacement (TARR) were evaluated using mechanical valve grafts in selected patients.
From January 1993 to December 2003, 100 patients (87 men), aged >65 years (mean 51 (SD 10.4 years), presenting with isolated aortic root dilatation with or without aortic valve insufficiency, undergoing elective root replacement using a mechanical valve graft were reviewed. The aetiology of aortic root disease was degenerative in 69 patients and related to the bicuspid aortic valve in 31 patients. In 11 patients, concomitant coronary artery bypass graft was performed. Hospital mortality was 4%. Overall survival was 93.9% (2.4%), 89.1% (3.5%) and 83.2% (5.2%) at 1, 5 and 7 years, respectively. 14 patients experienced 45 embolic events (3.21 (2.64) events/patient; range: 1-10 events). Thus, the linearised rate of embolic events was 10.3 per 100 patient-years (95% confidence interval (CI) 7.29 to 13.31). The actuarial embolism-free survival was 96.6% (1.9%), 77.1% (6%) and 74.3% (6.4%) at 1, 5 and 7 years, respectively. The linearised rate of bleeding events was 2.2 per 100 patient-years (95% CI 0.87 to 3.71). Actuarial bleeding free survival was 95.6% (2.1%), 93.2% (2.6%) and 87.7% (5.8%) at 1, 5 and 7 years. respectively. None of the patients required reoperation and no cases of structural or non-structural valve dysfunction were observed.
TARR using mechanical valve grafts yields excellent survival results in selected patients. However, a high rate of minor thromboembolic events was recorded. Aspirin in combination with oral anticoagulants might be of potential interest in these patients.
Keywords
Adolescent, Adult, Anticoagulants/therapeutic use, Aortic Diseases/surgery, Aortic Valve Insufficiency/surgery, Coronary Artery Bypass, Dilatation, Pathologic/surgery, Embolism/etiology, Epidemiologic Methods, Female, Heart Valve Prosthesis Implantation/methods, Humans, Male, Middle Aged, Postoperative Care/methods, Postoperative Complications, Postoperative Hemorrhage/etiology, Treatment Outcome
Pubmed
Web of science
Create date
30/03/2019 17:37
Last modification date
20/08/2019 12:49
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