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Comparative Study
. 2021 Apr 20;21(1):196.
doi: 10.1186/s12872-021-02014-5.

Mid-term outcomes of modified valve-sparing aortic root replacement versus the Bentall procedure for middle-aged Chinese patients with acute DeBakey I aortic dissection: a single-center retrospective study

Qingsong Wu #  1   2 , Zhisheng Wang #  3 , Zhihuang Qiu  1   2 , Yue Shen  1   2 , Xiaodong Chen  1   2 , Xingfeng Chen  1   2 , Liangwan Chen  4   5
Affiliations
Comparative Study

Mid-term outcomes of modified valve-sparing aortic root replacement versus the Bentall procedure for middle-aged Chinese patients with acute DeBakey I aortic dissection: a single-center retrospective study

Qingsong Wu et al. BMC Cardiovasc Disord. .

Abstract

Background: The mid-term and long-term efficacies of valve preservation in acute DeBakey I aortic dissection (AD) are controversial. Thus, it is unclear whether middle-aged patients with acute DeBakey I AD should undergo modified valve-sparing procedures or the Bentall procedure in an emergency setting.

Methods: This study included 213 middle-aged Chinese patients (under 60 years old) who were treated for acute DeBakey I AD between January 2009 and June 2015. The treatments involved modified valve-sparing aortic root replacement (VSARR) (117 patients) or the Bentall procedure (96 patients). Preoperative, intraoperative, postoperative, and follow-up data were analyzed. Echocardiography and thoracoabdominal computed tomography angiography (CTA) findings were reviewed at 3 months, 1 year, and then annually after surgery.

Results: No significant differences were observed in terms of the preoperative, intraoperative, in-hospital mortality, and postoperative parameters. There were also no significant differences in aortic regurgitation (AR). However, follow-up examinations using CTA revealed that 6 patients had endoleakage at the distal end of the triple-branched stent (0/110 patients [0.0%] vs. 6/90 patients [6.7%], P = 0.022). The anticoagulation-related thromboembolism/bleeding events was significantly lower in group A than in group B (0/110 patients [0.0%] vs. 11/90 patients [11.1%], P = 0.001). And postoperative aortic valve re-operation rate was significantly lower in group A (1/110 patients [0.9%] vs. 8/90 patients [8.9%], P = 0.020). There was no significant difference in survival during the follow-up period (log-rank P > 0.05).

Conclusion: For middle-aged patients with acute DeBakey I AD, VSARR were associated with a lower rate of endoleakage at the distal end of the triple-branched stent, thromboembolism/bleeding events and aortic valve re-operation (vs. the Bentall procedure).

Keywords: Acute DeBakey I aortic dissection; Aortic root surgery; Endoleakage; Middle-aged patients; Re-operation; Thromboembolism/bleeding events.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
In the noncoronary sinus, a vertical 3–0 polypropylene continuous suture was placed internally from the base of the sinus toward the transected edge of the aortic root
Fig. 2
Fig. 2
The modified valve-sparing aortic root technique using patch neointima technique
Fig. 3
Fig. 3
Survival curve 1
See this image and copyright information in PMC

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