Early and Short-term Outcomes of Adopting Aortic Valve Re-Implantation Technique Addressing DeBakey Type 1 Aortic Dissection
(2024). Early and Short-term Outcomes of Adopting Aortic Valve Re-Implantation Technique Addressing DeBakey Type 1 Aortic Dissection. EKB Journal Management System, 96(1), 2330-2336. doi: 10.21608/ejhm.2024.363590
. "Early and Short-term Outcomes of Adopting Aortic Valve Re-Implantation Technique Addressing DeBakey Type 1 Aortic Dissection". EKB Journal Management System, 96, 1, 2024, 2330-2336. doi: 10.21608/ejhm.2024.363590
(2024). 'Early and Short-term Outcomes of Adopting Aortic Valve Re-Implantation Technique Addressing DeBakey Type 1 Aortic Dissection', EKB Journal Management System, 96(1), pp. 2330-2336. doi: 10.21608/ejhm.2024.363590
Early and Short-term Outcomes of Adopting Aortic Valve Re-Implantation Technique Addressing DeBakey Type 1 Aortic Dissection. EKB Journal Management System, 2024; 96(1): 2330-2336. doi: 10.21608/ejhm.2024.363590

Early and Short-term Outcomes of Adopting Aortic Valve Re-Implantation Technique Addressing DeBakey Type 1 Aortic Dissection

The Egyptian Journal of Hospital Medicine
Article 3, Volume 96, Issue 1, July 2024, Page 2330-2336  XML PDF (302.32 K)
Document Type: Original Article
DOI: 10.21608/ejhm.2024.363590
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Abstract
Background: Acute aortic dissection is a critical medical condition that has a significant risk of death and morbidity. The Bentall procedure has become the accepted standard for treating aortic root pathology. The newer trend is to perform the aortic valve-sparing operations to prevent various risks related to prosthetic valves. Objective: This study primarily aimed at assessment of the early and short-term results of adopting aortic valve re-implantation technique (Tirone David) addressing DeBakey Type 1 aortic dissection including cardiac function assessment, major cardiac problems, clinical status, quality of life and mortality over 1-year follow-up. Patients and Methods: This retrospective study included 49 patients with acute aortic dissection DeBakeytype 1 associated with severe aortic incompetence (AI), intramural hematoma involving the ascending aorta and/or penetrating atherosclerotic ulcer in the ascending aorta. They were operated upon using aortic valve re-implantation technique (Tirone David). Results: The mean age was 54.15±13.77 years. Mortality was 0% intraoperatively, 5(10.20%) operative mortality, no late mortality and the overall 1-year survival rate was 44(89.80%). The overall hospital complications rate was13 (26.53%). At 1-year follow-up, there were statistically significant improvements in left ventricular ejection fraction per cent (LVEF%), left ventricular end-diastolic diameter (LVEDD)(p < 0.001), left ventricular end-systolic diameter (LVESD) (p < 0.001) and AI degree. LVEF improved from 52.54±9.16% preoperatively to 55.67±8.35% (p=0.015). AI degree improved from severe AI in 100% of cases to no or trivial AI in 28(63.63%) patients, mild AI in 15(34.09%) patients, moderate AI in 1(2.27%) patient and no patients with severe AI (p < 0.001). There were no complications in the form of aortic valve (AV) failure. Conclusion: The procedure of preservation of the patient’s native aortic valve through re-implantation technique (Tirone David operation), when appropriate, is recommended as it allows better left ventricular performance and avoiding the development of valve-related complications (endocarditis, thromboembolic complications and life-long anticoagulation).
 
Keywords
Acute aortic dissection; Aortic valve re-implantation; Tirone David
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