Durability of aortic valve preservation with root reconstruction for acute type A aortic dissection

Abstract

Aortic valve preservation and root reconstruction appear to be an appropriate surgical approach to AAAD.

The outcome of surgical management of type A aortic dissection

“…In our series, dissection involved the aortic root in 16 (14.8%) patients and the aortic arch in 9 (8.3%); however, replacement of the aortic arch and root was not associated with increased morbidity and mortality. Although these results are in agreement with the current literature, [10][11][12] we cannot make a statement in this regard due to our small sample size. Some other studies have reported higher morbidity and mortality for arch replacement compared to ascending replacement only.…”

Fibrin Sealant Patch for Repair of Acute Type A Aortic Dissection

“…Gelatin‐resorcin‐formaldehyde glue (GRF) has been successfully used in aortic dissection surgery for decades . However, due to its tissue toxicity (probably due to the formaldehyde) and several series showing increased rates of the long‐term complications mentioned above, its use in these procedures has raised concerns. Albumin‐resorcin glue is believed to be less tissue toxic; however, it hardens quickly and becomes very rigid which makes dosing, uniform placement and the placement of stiches sometimes difficult; long‐term complications have been reported as well .…”

Late echocardiographic study of aortic valve and aortic root after surgery for type a acute aortic dissection

“…concluded that preservation of the aortic valve is associated to an increased risk of recurrent AR in patients presenting with moderate-to-severe AR;[18] Yamanaka et al . showed that high-grade preoperative AR improved during the postoperative follow-up after valve preservation with root reconstruction;[7] on the contrary, Bekkers et al . demonstrated that the aortic valve preservation in patients with severe preoperative AR was associated with an increased risk of aortic valve re-operation.…”

“…[67] AAD is often associated with a variable degree of concomitant aortic valve regurgitation (AR); emergency surgery has to also address the aortic valve function. [89] The choice between either conservative approach or replacement of the aortic valve is crucial and basically relies on the degree of aortic root involvement, aortic valve morphology, and the underlying mechanism of AR.…”