Abstract 17654: Survival After Biological Aortic Root Replacement: A Contemporary Series of 310 Consecutive Patients
OBJECTIVES: Contemporary outcome after biological aortic root replacement is determined in a large consecutive series.
METHODS: From 03/2006-06/2011, 310 consecutive patients (pts; male:212; mean age: 67.4±9 yrs) underwent composite biological aortic root replacement: 64% for (degenerative or atherosclerotic) root/ascending aortic aneurysm (R/AsA,N=198 [male:147,mean age:67.9±9 yrs]), 11% for acute type A aortic dissection (AAD,N=34 [male:17,mean age:69.9±10 yrs]) and 16% for active infective endocarditis (AIE,N=49 [male:39,mean age:68.9±9 yrs]). Twenty-nine patients (9%) mandated composite root replacement for other reasons (fragile tissue, intraoperative complications  or narrow aortic annulus). 24% (N=74) of all pts had reoperative or redo procedures [male:48, mean age: 69.9±9 yrs].
RESULTS: Overall In-house mortality was 12.9% (N=40), 6.1% (N=12) for R/AsA, 17.6% (N=6) for AAD and 26.5% (N=13) for AIE. Concomitant cardiac procedures were performed in 59.4% (N=184): in 47% of R/AsA (N=93), in 11.8% of AAD (N=4) and in 40.8% of the AIE (N=20) pts. Overall mortality after 1-year was 4.5% (N=11) and did not differ between the subgroups (2.8% R/AsA, 4.5% AAD and 6.9% AIE, p=0.24). Survival for pts. after biological composite root replacement was similar to their age and sex matched normal population. Women after biological root replacement had an inferior longevity compared to men, even after age adjustment (m:f= 45/212 vs 32/98, p=0.03).
CONCLUSIONS: First-year survivors, after biological composite aortic root replacement, enjoy equivalent longevity regardless of etiology. After hospital discharge, longevity is equivalent to a normal age-matched population, however, inferior for women.
- © 2012 by American Heart Association, Inc.