• J. Thorac. Cardiovasc. Surg. · Feb 2018

    Longer-term results, z scores, and decision nomograms for treatment of the ascending aorta in 1693 bicuspid aortic valve operations.

    • Hans-Hinrich Sievers, Sina Stock, Ulrich Stierle, Stefan Klotz, Efstratios I Charitos, Michael Diwoky, and Doreen Richardt.
    • Department of Cardiac and Thoracic Vascular Surgery, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Germany. Electronic address: Hans-Hinrich.Sievers@uksh.de.
    • J. Thorac. Cardiovasc. Surg. 2018 Feb 1; 155 (2): 549-559.e2.

    ObjectiveThis study aims to fine-tune the decision making for ascending aorta treatment in bicuspid aortic valve surgery.MethodsA total of 1693 patients with a primary indication for aortic valve surgery were investigated retrospectively with respect to a multifactorial decision-making policy including the z score and the clinical outcome in relation to different techniques for ascending aorta treatment (no intervention n = 1116; intervention n = 577 either by ascending aorta replacement n = 404 or aortoplasty n = 173). Follow-up was 99.5% complete (mean 7.0 ± 4.4 years, range 0-17.7 years, 11,895 patient-years).ResultsHospital mortality was 1.2% for the no-intervention group and 0.9% for the intervention group and was not different between groups (P = .629). Survival compared with the adjusted normal population was lower for both groups (no intervention: P < .001) but not by such a great margin for the intervention group (P = .27). Determinants for death were not related to the ascending aorta treatment. Aortoplasty led to significantly more reoperations (P = .002). The z score thresholds for intervention on the ascending aorta were greater for younger patients, intervention was more liberal in young age, depicted in nomograms.ConclusionsIn our study, ascending aorta intervention could be performed with low hospital mortality and obviously did not add to the overall mortality compared with no intervention. Ascending aorta replacement was the most definite intervention. The multifactorial decision for ascending aorta intervention including the z score of the ascending aorta was more liberal in younger patients compared to the simple aortic size guidelines and provided excellent results. However, generalizability needs further data.Copyright © 2017 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

      Pubmed     Free full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…