Frontiers in cardiovascular medicine · 2025
To replace or not to replace the aortic valve during Type A Aortic Dissection surgery: early and mid-term results.
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Yaşar Muhammet Selim, Külahcıoğlu Emre, Küçüker Şeref Alp
Аннотация
AIM: The decision to replace or not to replace the aortic valve in the surgical treatment of Type A Aortic Dissection can be complicated in hesitant cases. It is controversial which procedure should be used in such cases and may significantly alter intraoperative/postoperative patient care and disease prognosis in an operation with a high mortality and morbidity rate, such as Type Aortic Dissection Surgery. In this study, we aim to compare the early and mid-term results of these two different methods.
METHODS: Between February 2019 and September 2022, 112 consecutive patients examined who underwent operation for TYPE A AORTIC DISSECTION in our clinic, retrospectively. Patients were than divided into two groups: those who the valve replaced group (Modified Bentall Procedure, SGI + AVR), (n = 26, 23.2%), and those who had the not valve replaced group (Isolated SGI, David II procedure, AV Resuspension), (n = 86, 76.8%).
RESULTS: It was observed that the X-Clamp and CPB times were longer and the need for postoperative mechanical support was higher in the valve replaced group (p < 0.05). Although it was not statistically significant, the false lumen patency rate was higher and the survival time was lower in the valve replaced group. In the postoperative controls, moderate-to-severe aortic regurgitation was not seen in any of the patients who had preoperative moderate-to-severe aortic regurgitation in the not valve replaced group and there was no sinus valsalva aneurysm in any patient.
CONCLUSION: When the intraoperative and postoperative results in our study were evaluated, it was concluded that the not valve replaced was superior to the valve replaced procedures for TYPE A AORTIC DISSECTION patients.
METHODS: Between February 2019 and September 2022, 112 consecutive patients examined who underwent operation for TYPE A AORTIC DISSECTION in our clinic, retrospectively. Patients were than divided into two groups: those who the valve replaced group (Modified Bentall Procedure, SGI + AVR), (n = 26, 23.2%), and those who had the not valve replaced group (Isolated SGI, David II procedure, AV Resuspension), (n = 86, 76.8%).
RESULTS: It was observed that the X-Clamp and CPB times were longer and the need for postoperative mechanical support was higher in the valve replaced group (p < 0.05). Although it was not statistically significant, the false lumen patency rate was higher and the survival time was lower in the valve replaced group. In the postoperative controls, moderate-to-severe aortic regurgitation was not seen in any of the patients who had preoperative moderate-to-severe aortic regurgitation in the not valve replaced group and there was no sinus valsalva aneurysm in any patient.
CONCLUSION: When the intraoperative and postoperative results in our study were evaluated, it was concluded that the not valve replaced was superior to the valve replaced procedures for TYPE A AORTIC DISSECTION patients.