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Author Lim, Ju Y. ♦ Jung, Sung H. ♦ Kim, Joon B. ♦ Kim, Dong K. ♦ Chung, Cheol H. ♦ Song, Hyun ♦ Lee, Jae W. ♦ Choo, Suk J.
Source World Health Organization (WHO)-Global Index Medicus
Content type Text
Publisher Wiley
File Format HTM / HTML
Language English
Difficulty Level Medium
Subject Domain (in DDC) Natural sciences & mathematics ♦ Life sciences; biology ♦ Natural history of organisms ♦ Technology ♦ Medicine & health ♦ Human anatomy, cytology, histology ♦ Diseases ♦ Surgery & related medical specialties ♦ Manufacture for specific uses ♦ Precision instruments & other devices
Subject Domain (in MeSH) Cardiovascular System ♦ Anatomy ♦ Eukaryota ♦ Organisms ♦ Cardiovascular Diseases ♦ Pathological Conditions, Signs and Symptoms ♦ Diseases ♦ Diagnosis ♦ Surgical Procedures, Operative ♦ Investigative Techniques ♦ Analytical, Diagnostic and Therapeutic Techniques and Equipment ♦ Persons ♦ Persons
Subject Keyword Discipline Cardiology ♦ Discipline Surgery ♦ Aorta ♦ Surgery ♦ Aortic Valve Stenosis ♦ Aortic Valve ♦ Blood Vessel Prosthesis Implantation ♦ Postoperative Complications ♦ Mortality ♦ Aged ♦ Cause Of Death ♦ Dilatation, Pathologic ♦ Echocardiography ♦ Echocardiography, Transesophageal ♦ Female ♦ Follow-up Studies ♦ Humans ♦ Male ♦ Middle Aged ♦ Etiology ♦ Prognosis ♦ Proportional Hazards Models ♦ Risk ♦ Survival Analysis ♦ Journal Article ♦ Research Support, Non-u.s. Gov't
Abstract BACKGROUND: Concerns of increased surgical risks with ascending aortic replacement have led surgeons to manage post-stenotic aortic dilatation more conservatively during aortic valve replacement (AVR). The present study aimed to assess the prognostic implications and surgical risks of replacing the dilated aorta during AVR. METHODS: Between January 1999 and March 2010, 134 patients who received surgery for aortic stenosis and post-stenotic dilatation (aorta size ≥40 mm) were included in the present study. AVR was performed in 92 patients (AVR group) while aortic valve and ascending aorta replacement (AVR + aorta group) were performed in 42 patients. Overall survival was compared between the two groups using Cox proportional hazard model after adjustment with inverse-probability-of-treatment weighting. RESULTS: The mean follow-up duration was 3.5 ± 3 years. There were no significant differences in the operative mortality and morbidity between the two groups. The late cardiac deaths were also not significantly different between the two groups (p = 1.00). In the AVR group, the ascending aortic expansion rate which was 0.18 mm/year over a mean follow-up duration of 2.3 ± 2.2 years by echocardiography showed a positive correlation with time (r = 0.3, p = 0.08). A relatively greater aortic expansion rate was identified as a risk factor for late mortality (p = 0.015, HR 1.08 (CI: 1.02 to 1.15). CONCLUSIONS: Concomitant replacement of the dilated ascending aorta during AVR did not increase the immediate postoperative morbidity or mortality risks and tended to exert a long-term beneficial effect on the risk of late mortality.
Description Author Affiliation: Lim JY ( Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea.)
ISSN 08860440
Educational Role Student ♦ Teacher
Age Range above 22 year
Educational Use Reading ♦ Research ♦ Self Learning
Interactivity Type Expositive
Education Level UG and PG
Learning Resource Type Article
Publisher Date 2013-05-01
Publisher Place United States
e-ISSN 15408191
Journal Journal of Cardiac Surgery
Volume Number 28
Issue Number 3


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Source: WHO-Global Index Medicus