Modified selective aortic root reconstruction with valve repair for treatment of Stanford A aortic dissection

Abstract

BackgroundAcute aortic dissection is a serious emergency with a significant impact on mortality and morbidity. Many patients present with hemodynamic instability that may prevent them from being transported to more experienced centers. We aim to present our experience with a modified limited root approach in terms of the operative details and early results.ResultsThis retrospective study included 27 patients who presented with Stanford A aortic dissection and underwent modified selective root replacement. All patients were followed up using transthoracic echocardiography at 6 months postoperatively and at yearly intervals thereafter. Computed tomography (CT) angiography was performed 12 months after the initial surgery.A total of 92.6% of patients required concomitant aortic valve repair. There was no operative mortality related to the operation itself; however, four patients died during the follow-up period. One patient developed new severe aortic regurgitation in the 6th month of follow-up. One patient developed a pseudoaneurysm related to the suture line that was diagnosed by CT angiography in the 16th month of follow-up.ConclusionsThe early results of modified selective root reconstruction with aortic valve repair are promising. This procedure is a quick, reliable, easily reproducible, and technically undemanding valve-sparing treatment for acute aortic root dissection.