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Management of dilated ascending aorta during aortic valve replacement: Valve replacement alone versus aorta wrapping versus aorta replacement

DC FieldValueLanguage
dc.contributor.author이승현-
dc.date.accessioned2014-12-18T09:55:53Z-
dc.date.available2014-12-18T09:55:53Z-
dc.date.issued2013-
dc.identifier.issn0022-5223-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/89098-
dc.description.abstractOBJECTIVES: The optimal management of dilated ascending aorta during aortic valve replacement (AVR) remains controversial. This study compared the outcomes among 3 different managements (AVR alone, aorta wrapping, and aorta replacement) for the dilated ascending aorta. METHODS: The study enrolled 499 consecutive non-Marfan patients undergoing AVR in the presence of the ascending aorta dilatation (40 to 55 mm). We evaluated rates of death and aortic events; in addition, we evaluated the aortic expansion rate by serial echocardiography. RESULTS: The surgery involved AVR alone (n = 362), aorta wrapping (n = 67), or aorta replacement (n = 70). Early mortality occurred in 1.2% (n = 6, P = .61). Throughout 1590.0 patient-years of follow-up, 47 deaths occurred. The 5-year survival rates were 90.1% ± 2.0%, 91.8% ± 3.5%, and 82.2% ± 7.5% in the AVR alone, aorta wrapping, and aorta replacement groups, respectively (P = .64). One aortic event (acute type A dissection) occurred in the AVR alone group. For the AVR alone group, the median aortic expansion rate was -0.6 mm/y (interquartile range, -3.2 to 0.6 mm/y). The aortic expansion rates were affected neither by the morphology of aortic valves (bicuspid vs tricuspid; P = .10) nor by the initial aorta diameter (γ = -0.31, P = .61). Clinically relevant aortic expansion (≥5 mm/y) was observed only in 5 patients; of these patients, 2 showed the aortic diameter of 60 mm or greater at the end of follow-up. CONCLUSIONS: Compared with concomitant aortic wrapping or replacement, AVR alone achieved similar clinical outcomes, showing considerably low risks of adverse aortic events or relevant aortic expansion in dilated ascending aorta. These findings argue against routine aortic replacement at the time of AVR.-
dc.description.statementOfResponsibilityopen-
dc.relation.isPartOfJournal of Thoracic and Cardiovascular Surgery-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.subject.MESHAged-
dc.subject.MESHAorta/diagnostic imaging-
dc.subject.MESHAorta/pathology-
dc.subject.MESHAorta/surgery*-
dc.subject.MESHAortic Aneurysm/diagnosis-
dc.subject.MESHAortic Aneurysm/mortality-
dc.subject.MESHAortic Aneurysm/surgery*-
dc.subject.MESHAortic Valve/surgery*-
dc.subject.MESHBlood Vessel Prosthesis Implantation*/adverse effects-
dc.subject.MESHBlood Vessel Prosthesis Implantation*/mortality-
dc.subject.MESHChi-Square Distribution-
dc.subject.MESHDilatation, Pathologic-
dc.subject.MESHFemale-
dc.subject.MESHHeart Valve Diseases/diagnosis-
dc.subject.MESHHeart Valve Diseases/mortality-
dc.subject.MESHHeart Valve Diseases/surgery*-
dc.subject.MESHHeart Valve Prosthesis Implantation*/adverse effects-
dc.subject.MESHHeart Valve Prosthesis Implantation*/mortality-
dc.subject.MESHHumans-
dc.subject.MESHKaplan-Meier Estimate-
dc.subject.MESHMale-
dc.subject.MESHMiddle Aged-
dc.subject.MESHRetrospective Studies-
dc.subject.MESHSurvival Rate-
dc.subject.MESHTime Factors-
dc.subject.MESHTreatment Outcome-
dc.subject.MESHUltrasonography-
dc.titleManagement of dilated ascending aorta during aortic valve replacement: Valve replacement alone versus aorta wrapping versus aorta replacement-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Thoracic & Cardiovascular Surgery (흉부외과학)-
dc.contributor.googleauthorSeung Hyun Lee-
dc.contributor.googleauthorJoon Bum Kim-
dc.contributor.googleauthorDong Hee Kim-
dc.contributor.googleauthorSung-Ho Jung-
dc.contributor.googleauthorSuk Jung Choo-
dc.contributor.googleauthorCheol Hyun Chung-
dc.contributor.googleauthorJae Won Lee-
dc.identifier.doi10.1016/j.jtcvs.2013.06.007-
dc.admin.authorfalse-
dc.admin.mappingfalse-
dc.contributor.localIdA02935-
dc.relation.journalcodeJ01906-
dc.identifier.pmid23856198-
dc.identifier.urlhttp://www.sciencedirect.com/science/article/pii/S0022522313006156-
dc.subject.keyword26.1.3-
dc.subject.keyword35.2-
dc.subject.keywordAVR-
dc.subject.keywordBAV-
dc.subject.keywordCT-
dc.subject.keywordIQR-
dc.subject.keywordLV-
dc.subject.keywordTAV-
dc.subject.keywordaortic valve replacement-
dc.subject.keywordbicuspid aortic valve-
dc.subject.keywordcomputed tomographic-
dc.subject.keywordinterquartile range-
dc.subject.keywordleft ventricular-
dc.subject.keywordtricuspid aortic valve-
dc.contributor.alternativeNameLee, Seung Hyun-
dc.contributor.affiliatedAuthorLee, Seung Hyun-
dc.rights.accessRightsnot free-
dc.citation.volume146-
dc.citation.number4-
dc.citation.startPage802-
dc.citation.endPage809-
dc.identifier.bibliographicCitationJournal of Thoracic and Cardiovascular Surgery, Vol.146(4) : 802-809, 2013-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers

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