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OC78 THE ROLE OF CORONARY SINUS-SPARING TECHNIQUE FOR TREATMENT OF AORTIC ROOT ANEURYSM IN PATIENTS WITH BICUSPID AORTIC VALVE

PRELIMINARY LONG-TERM FOLLOW UP RESULTS

Pradegan, N.1; Azzolina, D.2; Fusca, S.1; Besola, L.1; Fabozzo, A.1; Rubino, M.1; Testolin, L.1; Bianco, R.1; Gerosa, G.1

Journal of Cardiovascular Medicine: November 2018 - Volume 19 - Issue - p e1
doi: 10.2459/01.JCM.0000549846.04600.f3
1. ORAL PRESENTATION - AORTA SATURDAY 24 - 08.00-10.00
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Background and Aim: to analyze late outcomes and fate of aortic root in patients with bicuspid aortic valve with antero-posterior orientation (BAV-AP) and aortic dilation undergoing ascending aorta replacement extended to the non-coronary sinus (NCS) (coronary-sinus sparing technique).

Methods: clinical and echocardiographic data of patients with BAV-AP scheduled for ascending aorta and root aneurysm repair and undergone ascending aorta replacement with coronary sinus-sparing technique at a single Center between 2000 and 2013 were retrospectively reviewed. Patients undergone redo operations or emergent surgery were excluded.

Results: 69 patients (males n = 63, median age 66 years, IQ range 48–66) underwent coronary-sinus sparing technique: 50 (72%) required associated aortic valve replacement. There were no hospital deaths. Only 1 major postoperative bleeding requiring reintervention happened. At 15-years follow up (completeness 96%), 13 (19%) patients died, but only 4 (6%) due to cardiovascular deaths. Only 6 (9%) patients underwent cardiac reoperation (none for root dilation). No aortic dissections occurred. At follow up all patients are in good clinical status with only 7 (10%) patients with NYHA II-III. Echocardiographic analysis of available data showed significant reduction of root diameter after intervention, with slightly increase at follow up (Figure 1).

Conclusions: coronary sinus-sparing technique with ascending aorta replacement extended to NCS in patients scheduled for aortic aneurysm repair with BAV-AP and asymmetrical root enlargement is a safe and low risk procedure, with good results in terms of late survival and freedom from root reintervention. This procedure reduces preoperative root diameter, granting nearly stable results at long-term follow up.

1UOC Cardiochirurgia, Dipartimento di Scienze Cardiologiche, Toraciche e Vascolari, Università di Padova Padova

2Biostatistica, Dipartimento di Scienze Cardiologiche, Toraciche e Vascolari, Università di Padova Padova

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