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The mid-term outcomes of aortic root replacement after surgical repair for CHD

Published online by Cambridge University Press:  13 November 2023

Akihisa Furuta Open the ORCID record for Akihisa Furuta [Opens in a new window] ,
Takeshi Shinkawa ,
Saeko Yoshizawa ,
Satoshi Okugi  and
Hiroshi Niinami
Akihisa Furuta
Affiliation:
Department of Cardiovascular Surgery, The Heart Institute of Japan, Tokyo Women’s Medical University, Shinjuku-ku, Japan
Takeshi Shinkawa*
Affiliation:
Department of Cardiovascular Surgery, The Heart Institute of Japan, Tokyo Women’s Medical University, Shinjuku-ku, Japan
Saeko Yoshizawa
Affiliation:
Department of Surgical Pathology, Tokyo Women’s Medical University, Shinjuku-ku, Japan
Satoshi Okugi
Affiliation:
Department of Cardiovascular Surgery, The Heart Institute of Japan, Tokyo Women’s Medical University, Shinjuku-ku, Japan
Hiroshi Niinami
Affiliation:
Department of Cardiovascular Surgery, The Heart Institute of Japan, Tokyo Women’s Medical University, Shinjuku-ku, Japan
*
Corresponding author: T. Shinkawa; Email: shinkawa.takeshi@twmu.ac.jp
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Abstract

Objective:

The purpose of this study is to assess the mid-term outcomes of aortic root replacement after repair of CHDs.

Method:

This is a single-institutional retrospective, cohort study with consecutive patients undergoing aortic root replacement after surgical repair of CHDs between 1999 and 2022. Operative indications included aortic root dilatation with/without aortic insufficiency, sinus of Valsalva rupture, or aortic dissection involving the root.

Results:

Forty-four patients (36 male and 8 female) were enrolled. Mean age at the root replacement was 36.6 ± 11.9 years. The most frequent primary diagnosis was congenital aortic stenosis (n = 10) and ventricular septal defect (n = 10). Mean time from the surgical repair to aortic root replacement was 26.6 ± 13.0 years. Operative indications were aortic root enlargement with or without aortic valve aetiology (n = 40), sinus of Valsalva rupture (n = 2), and aortic dissection (n = 2). Forty-two patients underwent valve-replacing aortic root replacement, and two patients underwent valve-sparing, with 40 concomitant procedures. The median follow-up was 3.5 (1.3–7.6) years. There were one early and five late mortalities and five cardiovascular-related reoperations. Actuarial survival at 5–10 years after root replacement was 81.0 ± 6.6%. The cumulative incidence of cardiovascular-related reoperation and aortic root or valve-related reoperation at 5 years after root replacement was 11.9% and 5.6%, respectively.

Conclusion:

The early and mid-term outcomes of aortic root replacement for patients with a history of repair of CHDs were favourable in terms of survival and aortic root or valve-related reoperation.

Keywords

aortic root diseasevalve-replacing aortic root replacementvalve-sparing aortic root replacementCHD
Type
Original Article
Information
Cardiology in the Young , Volume 34 , Issue 4 , April 2024 , pp. 891 - 899
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Copyright
© The Author(s), 2023. Published by Cambridge University Press

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