Midterm Outcomes of Graft Insertion Technique for Redo Aortic Root Surgery.

PURPOSE: This study evaluated the midterm outcomes, including adverse aortic events (AAEs), of the "graft insertion technique" (GIT) for left ventricular outflow tract (LVOT) and aortic root reconstruction.

METHODS

From August 2014 to March 2024, 14 consecutive patients underwent GIT for LVOT and aortic root reconstruction. The indications for surgery were prosthetic valve endocarditis in 9 cases and noninfectious pseudoaneurysm in 5 cases. Among these patients, seven (50.0%) underwent aortic root surgery, while the other seven (50.0%) underwent aortic valve replacement alone or in combination with other procedures without aortic root surgery. Their mean EuroSCORE II was 28.8 ± 17.6.

RESULTS

The mean total operation time was 504 ± 87 min. The mean cardiopulmonary bypass and aortic cross-clamp times were 311 ± 41 and 240 ± 45 min, respectively. Operative mortality occurred in one case (7.1%), and five patients (35.7%) died during the first year of follow-up. No surviving patients experienced recurrent endocarditis. No patients died from cardiovascular events or infections after the second year of follow-up. Furthermore, no AAEs were observed on computed tomography during the follow-up period after hospital discharge.

CONCLUSION

GIT is a feasible alternative for high-risk cases of redo aortic root surgery.