Thorac Cardiovasc Surg
DOI: 10.1055/s-0041-1723844
Original Cardiovascular

Aortic Root Replacement with Reimplantation of the Aortic Valve: A Low-Volume Center Experience

1  Department of Cardiac Surgery, Municipal Hospital Triemli, Zurich, Switzerland
,
Nestoras Papadopoulos
1  Department of Cardiac Surgery, Municipal Hospital Triemli, Zurich, Switzerland
,
Dragan Odavic
1  Department of Cardiac Surgery, Municipal Hospital Triemli, Zurich, Switzerland
,
Achim Haeussler
1  Department of Cardiac Surgery, Municipal Hospital Triemli, Zurich, Switzerland
,
Helen Loeblein
1  Department of Cardiac Surgery, Municipal Hospital Triemli, Zurich, Switzerland
,
Omer Dzemali
1  Department of Cardiac Surgery, Municipal Hospital Triemli, Zurich, Switzerland
› Author Affiliations
Funding No funding received for this study.

Abstract

Background Most data after root replacement with reimplantation of the aortic valve originate from high-volume centers. This raises concerns about the generalizability of these data and the reproducibility of this complex procedure. Aim of this study is to assess the perioperative and midterm outcomes of this procedure in a low-volume center.

Methods We performed a retrospective analysis of the data of 72 patients, who underwent root replacement with reimplantation of the aortic valve in a single center between 2011 and 2020. Time to event analysis was performed with Kaplan–Meier curves. Longitudinal analysis of serial echocardiographic data was performed with a mixed-effects ordinal logistic regression model.

Results In-hospital mortality was 1.4%, with absence of any neurological events during the perioperative period. At midterm follow-up, two further patients died. Overall survival rates at 1 and 5 years were 98.5% (95% confidence interval [CI]: 97–100%) and 96.3% (95% CI: 93.8–98.8%), respectively. During follow-up, five patients (6.9%) required reoperation on the aortic valve. The incidence of moderate and severe aortic regurgitation at 5 years was 6.6% (95% CI: 2.4–13.6%) and 0.6% (95% CI: 0.1–3.2%), respectively. Mild aortic regurgitation at hospital discharge (p < 0.001) and cusp plication (p = 0.0121) were associated with a higher incidence of moderate or severe aortic regurgitation at follow-up.

Conclusion Reimplantation of the aortic valve is safe and feasible even in a low-volume center. Mortality, freedom from reoperation, and incidence of moderate or severe aortic regurgitation at follow-up are comparable to those of high-volume centers.



Publication History

Received: 23 October 2020

Accepted: 29 December 2020

Publication Date:
18 February 2021 (online)

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