| P298 | Valve-Sparing Aortic Root Reimplantation after Previous Cardiac Surgery. |
| R.Leyh, K.Kallenbach, Chr.Hagl, A.Ruhparwar, M.Karck, A.Haverich | |
| Medizinische Hochschule Hannover, THG-Chirurgie, Hannover. | |
|
Background: Valve-sparing aortic root reimplantation have provided excellent results. Thus, the list of indications for valve sparing aortic root reimplantation has been expanded to patients requiring extensive concomitant cardiac surgical interventions. However, little data are available regarding the feasibility and outcome of valve-sparing aortic root reimplantation in patients after previous cardiac surgery. Methods: From July 1993 to January 2003, 220 patients underwent a valve sparing aortic root reimplantation at our institution. Nine of these had previous cardiac surgery. Previous operations were supracommisural replacement of the ascending aorta for acute type A aortic dissection (n=3), supracommisural replacement of the ascending aorta for aorta ascending aneurysm (n=1), Ross procedure (n=1), acute type A aortic dissection after heart transplantation (n=1), repair of tetralogy of Fallot (n=1), and Coronary artery bypass grafting (n=2). Results: There was one hospital death. One patient died 8 months postoperatively due to non-cardiac reason. Mean follow-up was 34 ± 12 months and 100% complete. Follow-up of aortic valve function showed no aortic valve regurgitation and normal aortic valve pressure gradients. At the last follow-up all survivors were NYHA-graded I and II. Conclusions: Reoperative valve sparing aortic root reimplantation is a technically demanding procedure. However, expertise in this area leads to excellent functional results even after previous cardiac surgery. |