Mortality and morbidity after aortic root replacement: 10-year experience

Abstract

Aortic root reconstruction remains a challenging surgical procedure. This retrospective study was carried out to evaluate the early and long-term outcomes of aortic root replacement over a 10-year period. There were 83 patients with a mean age of 43.2 +/- 14 years (range, 10 to 78 years). Type A aortic dissection and Marfan syndrome were found in 28% and 24%, respectively. The most common technique used for repair of this condition was the Bentall operation. The mean duration of follow-up was 29.6 +/- 28 months, ranging from 1 to 120 months. Hospital (30-day) mortality was 13.3% (11 patients). Two patients died during the late follow-up. The mortality was significantly higher in patients presenting with cardiogenic shock, those with long cardiopulmonary bypass and crossclamp times, and the group who had concomitant coronary artery bypass grafting. Emergency operation was not a significant risk factor for early death in our patients. The most common complications were bleeding and neurological sequelae. Aortic root replacement can be achieved with acceptable mortality and morbidity in a high-risk group of patients. Improvements in the outcome may be achieved by faster transport of patients in cardiogenic shock, and by reducing the cardiopulmonary bypass and crossclamp times.