Valve-sparing aortic root replacement in acute type A aortic dissection

Süleyman Sürer, İbrahim Duvan, İlker İnce, Özgür Ersoy, Uğursay Kızıltepe

Abstract

Aim: The aortic valve-sparing procedure is an elective option for patients with aortic aneurysms. The feasibility of the surgical method in treating acute type A aortic dissection is still controversial. We aimed to study the outcomes of the David V aortic valve-sparing root replacement procedure.
Methods: We studied 21 acute type A aortic dissection patients who received the David V re-implantation technique. Patients were followed up with annual postoperative echocardiograms. Follow-up was 100% complete, with a mean duration of 40±26 months.
Results: In 15 (71%) patients, the David V re-implantation technique was performed together with hemiarch; in 6 (29%) patients, it was combined with total aortic arch replacement. Three (14%) patients died in the hospital. None of the patients developed aortic regurgitation (AI) greater than second-degree at discharge. One patient had 2+ AI during the follow-up period, and the others showed trace/no AI.
Conclusion: The David V operation can be considered for younger patients with suitable anatomy for acute type A aortic dissection with favourable outcomes.