PDF(Pubmed)
Abstract：
UNASSIGNED: Reoperative aortic root surgery has become more and more common over the years and is considered high-risk, with significantly worse outcomes compared to first-procedure root surgery. At our institution, this kind of surgery is frequently performed. The aim of the present review is to describe currently available literature on reoperative surgery on the aortic root in terms of patients\' population, indications for surgery and outcomes and to present our center\'s experience on the matter.
UNASSIGNED: A literature review was performed in order to identify pertinent studies. They were then compared and described. We also described preoperative characteristics, operative strategies and outcomes of all the patients who underwent redo aortic root surgery from January 1986 to December 2022 at our center.
UNASSIGNED: Our literature review identified 12 pertinent studies, with a total of 16,627 considered patients. The most frequent indications for redo surgery were endocarditis (35.5%), aneurysm, dissection and pseudoaneurysm. Mean cardiopulmonary bypass (CPB) and cross-clamp times were 218 and 152 minutes, respectively. In-hospital mortality was 12%. When analyzing our center\'s data, 344 procedures were identified. Aortic root dilation was the most frequent indication (36.9%). Mean CPB and cross-clamp times were 218.0±78.8 and 158.2±49.7 minutes, respectively. In-hospital mortality was 9.6%. Survival at 5 and 15 years was 76.1% and 51.4% respectively. Freedom from further aortic reintervention was 88.1% after 5 years and 64.9% after 15 years.
UNASSIGNED: Reoperative aortic root surgery is a difficult cardiac procedure which is linked to significantly higher mortality than first-time root replacement. If it is performed by experienced surgeons with a careful preoperative planning its result can still be satisfactory. Our results showed acceptable rates of mortality and reinterventions at follow-up. Endocarditis, however, was linked to worse outcomes.
UNASSIGNED: A literature review was performed in order to identify pertinent studies. They were then compared and described. We also described preoperative characteristics, operative strategies and outcomes of all the patients who underwent redo aortic root surgery from January 1986 to December 2022 at our center.
UNASSIGNED: Our literature review identified 12 pertinent studies, with a total of 16,627 considered patients. The most frequent indications for redo surgery were endocarditis (35.5%), aneurysm, dissection and pseudoaneurysm. Mean cardiopulmonary bypass (CPB) and cross-clamp times were 218 and 152 minutes, respectively. In-hospital mortality was 12%. When analyzing our center\'s data, 344 procedures were identified. Aortic root dilation was the most frequent indication (36.9%). Mean CPB and cross-clamp times were 218.0±78.8 and 158.2±49.7 minutes, respectively. In-hospital mortality was 9.6%. Survival at 5 and 15 years was 76.1% and 51.4% respectively. Freedom from further aortic reintervention was 88.1% after 5 years and 64.9% after 15 years.
UNASSIGNED: Reoperative aortic root surgery is a difficult cardiac procedure which is linked to significantly higher mortality than first-time root replacement. If it is performed by experienced surgeons with a careful preoperative planning its result can still be satisfactory. Our results showed acceptable rates of mortality and reinterventions at follow-up. Endocarditis, however, was linked to worse outcomes.
摘要：
■多年来，再次手术的主动脉根部手术变得越来越普遍，被认为是高风险的，与首例牙根手术相比，结果明显更差。在我们的机构，这种手术经常进行。本综述的目的是描述目前可获得的关于主动脉根部再手术的文献，手术适应症和结果，并介绍我们中心在此事上的经验。
■进行文献综述以确定相关研究。然后对它们进行了比较和描述。我们还描述了术前特征，1986年1月至2022年12月在我们中心接受了重做主动脉根部手术的所有患者的手术策略和结局.
■我们的文献综述确定了12项相关研究，共有16,627名患者。重做手术最常见的指征是心内膜炎（35.5％），动脉瘤,解剖和假性动脉瘤.平均体外循环（CPB）和交叉钳夹时间为218和152分钟，分别。住院死亡率为12%。在分析我们中心的数据时,已经确定了344个程序。主动脉根扩张是最常见的指征(36.9%)。平均CPB和交叉钳夹时间为218.0±78.8和158.2±49.7分钟，分别。住院死亡率为9.6%。5年和15年生存率分别为76.1%和51.4%。5年后无进一步主动脉再介入的发生率为88.1%，15年后为64.9%。
■再次手术主动脉根部手术是一项困难的心脏手术，其死亡率明显高于首次根部置换。如果由经验丰富的外科医生进行仔细的术前计划，其结果仍然可以令人满意。我们的结果显示死亡率和随访中的再干预率是可接受的。心内膜炎,然而,与更糟糕的结果有关。
■进行文献综述以确定相关研究。然后对它们进行了比较和描述。我们还描述了术前特征，1986年1月至2022年12月在我们中心接受了重做主动脉根部手术的所有患者的手术策略和结局.
■我们的文献综述确定了12项相关研究，共有16,627名患者。重做手术最常见的指征是心内膜炎（35.5％），动脉瘤,解剖和假性动脉瘤.平均体外循环（CPB）和交叉钳夹时间为218和152分钟，分别。住院死亡率为12%。在分析我们中心的数据时,已经确定了344个程序。主动脉根扩张是最常见的指征(36.9%)。平均CPB和交叉钳夹时间为218.0±78.8和158.2±49.7分钟，分别。住院死亡率为9.6%。5年和15年生存率分别为76.1%和51.4%。5年后无进一步主动脉再介入的发生率为88.1%，15年后为64.9%。
■再次手术主动脉根部手术是一项困难的心脏手术，其死亡率明显高于首次根部置换。如果由经验丰富的外科医生进行仔细的术前计划，其结果仍然可以令人满意。我们的结果显示死亡率和随访中的再干预率是可接受的。心内膜炎,然而,与更糟糕的结果有关。
