PMID- 21470869
OWN - NLM
STAT- MEDLINE
DCOM- 20120306
LR  - 20221207
IS  - 1873-734X (Electronic)
IS  - 1010-7940 (Linking)
VI  - 40
IP  - 5
DP  - 2011 Nov
TI  - Re-operations on the proximal thoracic aorta: results and predictors of short- 
      and long-term mortality in a series of 174 patients.
PG  - 1072-6
LID - 10.1016/j.ejcts.2011.02.039 [doi]
AB  - OBJECTIVE: The aim of this study was to report results and to identify predictors 
      of hospital and long-term mortality in patients undergoing re-operations on the 
      proximal thoracic aorta. METHODS: Between 1986 and 2009,174 re-operations on the 
      proximal thoracic aorta after previous aortic surgery were performed in our 
      Institution. The patients' mean age was 58 years, 132 (75.9%) were men. The mean 
      time from last operation was 9.9 years. An urgent operation was performed in 35 
      (20.1%) patients. Indications for surgery included degenerative and chronic 
      post-dissection aneurysm (n=133), acute dissection (n=8), false aneurysm (n=22), 
      and active prosthetic infection (n=11). Root procedures were performed in 65 
      (37.3%) patients, ascending aorta replacement in 27 (15.5%), different extents of 
      aortic arch replacement in 39 (22.4%), and root, ascending aorta and arch 
      replacement in 43 (24.7%). RESULTS: Hospital mortality was 12.6%. On multivariate 
      analysis, cardiopulmonary bypass (CPB) time (odds ratio (OR)=1.1018 per min), New 
      York Heart Association (NYHA) class III-IV (OR=3.86), and active endocarditis 
      (OR=5.15) emerged as independent predictors of hospital mortality. Mean follow-up 
      time was 56 months. The estimated 1-, 5-, and 10 years' survival were 81.6%, 
      74.2%, and 44.5%, respectively. On Cox regression analysis, age (hazard ratio 
      (HR)=1.037 per year) and CPB time (HR=1.010 per min) emerged as independent risk 
      factors of late mortality. CONCLUSIONS: Short- and long-term survival was 
      satisfactory being excellent in patients with degenerative aneurysms and dismal 
      in those with active endocarditis. Extensive aortic resections did not increase 
      hospital mortality and were associated with a reduced need for aortic 
      re-interventions. CPB time remains the most important risk factor for reduced 
      survival in aortic surgery.
CI  - Copyright (c) 2011 European Association for Cardio-Thoracic Surgery. Published by 
      Elsevier B.V. All rights reserved.
FAU - Di Eusanio, Marco
AU  - Di Eusanio M
AD  - Cardiac Surgery Department, Sant'Orsola-Malpighi Hospital, Bologna University, 
      Bologna, Italy. marco.dieusanio2@unibo.it
FAU - Berretta, Paolo
AU  - Berretta P
FAU - Bissoni, Luca
AU  - Bissoni L
FAU - Petridis, Francesco D
AU  - Petridis FD
FAU - Di Marco, Luca
AU  - Di Marco L
FAU - Di Bartolomeo, Roberto
AU  - Di Bartolomeo R
LA  - eng
PT  - Journal Article
DEP - 20110405
PL  - Germany
TA  - Eur J Cardiothorac Surg
JT  - European journal of cardio-thoracic surgery : official journal of the European 
      Association for Cardio-thoracic Surgery
JID - 8804069
SB  - IM
CIN - Eur J Cardiothorac Surg. 2011 Nov;40(5):1077. PMID: 21757368
MH  - Adult
MH  - Aged
MH  - Aortic Dissection/surgery
MH  - Aneurysm, False/surgery
MH  - Aorta, Thoracic/*surgery
MH  - Aortic Aneurysm, Thoracic/surgery
MH  - Aortic Diseases/*surgery
MH  - Aortic Valve/surgery
MH  - Blood Vessel Prosthesis/adverse effects
MH  - Blood Vessel Prosthesis Implantation/methods
MH  - Cardiopulmonary Bypass
MH  - Epidemiologic Methods
MH  - Female
MH  - Heart Valve Prosthesis Implantation
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Prosthesis-Related Infections/surgery
MH  - Reoperation/methods
MH  - Treatment Outcome
EDAT- 2011/04/08 06:00
MHDA- 2012/03/07 06:00
CRDT- 2011/04/08 06:00
PHST- 2010/11/19 00:00 [received]
PHST- 2011/02/03 00:00 [revised]
PHST- 2011/02/07 00:00 [accepted]
PHST- 2011/04/08 06:00 [entrez]
PHST- 2011/04/08 06:00 [pubmed]
PHST- 2012/03/07 06:00 [medline]
AID - S1010-7940(11)00238-7 [pii]
AID - 10.1016/j.ejcts.2011.02.039 [doi]
PST - ppublish
SO  - Eur J Cardiothorac Surg. 2011 Nov;40(5):1072-6. doi: 10.1016/j.ejcts.2011.02.039. 
      Epub 2011 Apr 5.