Universität zu Köln

Tkebuchava, Sophie, Tasar, Raphael, Lehmann, Thomas, Faerber, Gloria, Diab, Mahmoud, Breuer, Martin, Franke, Ulrich, Kirov, Hristo, Gummert, Jan, Lichtenberg, Artur, Wahlers, Thorsten and Doenst, Torsten (2020). Predictors of Outcome for Aortic Valve Reimplantation Including the Surgeon-A Single-Center Experience. Thorac. Cardiovasc. Surg., 68 (7). S. 567 - 575. STUTTGART: GEORG THIEME VERLAG KG. ISSN 1439-1902

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Abstract

Introduction Aortic valve reimplantation is considered technically demanding. We searched for predictors of long-term outcome including the surgeon as risk factor. Methods We selected all aortic valve reimplantations performed in our department between December 1999 and January 2017 and obtained a complete follow-up. The main indications were combined aortic aneurysm plus aortic valve regurgitation (AR), 69% and aortic dissections (15%). In 14%, valves were bicuspid. Cusp repair was performed in 27% of patients. One-third received additional procedures (coronary artery bypass grafting, mitral, or arch surgery). We performed multivariable analyses for independent risk factors of short- and long-term outcomes, including surgeon as variable. Twelve different surgeons operated on 193 patients. We created three groups: surgeons A and B with 84 and 64 procedures, respectively, and surgeon C (10 surgeons for 45 patients). Results Cardiopulmonary bypass and clamp times were 17645 and 130 +/- 24minutes, respectively. In-hospital mortality was 2%. Postoperatively, 5% had mild and 0.5% had moderate AR. Kaplan-Meier's survival estimates, freedom from reoperation, and freedom from severe AR at 12 years were 97 +/- 1, 93 +/- 2, and 91 +/- 3%, respectively. Age and chronic obstructive pulmonary disease appeared as risk factors for perioperative complications by univariate analysis. Age, coronary artery disease, and duration of cardiopulmonary bypass, but not surgeon, presented as risk factors by multivariable analysis. Conclusion The results suggest that if a David procedure is performed successfully, long-term durability may be excellent. They also suggest that good and durable results are possible even with limited experience of the operating surgeon.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Tkebuchava, Sophie UNSPECIFIED UNSPECIFIED UNSPECIFIED Tasar, Raphael UNSPECIFIED UNSPECIFIED UNSPECIFIED Lehmann, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Faerber, Gloria UNSPECIFIED UNSPECIFIED UNSPECIFIED Diab, Mahmoud UNSPECIFIED UNSPECIFIED UNSPECIFIED Breuer, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Franke, Ulrich UNSPECIFIED UNSPECIFIED UNSPECIFIED Kirov, Hristo UNSPECIFIED UNSPECIFIED UNSPECIFIED Gummert, Jan UNSPECIFIED UNSPECIFIED UNSPECIFIED Lichtenberg, Artur UNSPECIFIED UNSPECIFIED UNSPECIFIED Wahlers, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Doenst, Torsten UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-316856
DOI:	10.1055/s-0038-1675594
Journal or Publication Title:	Thorac. Cardiovasc. Surg.
Volume:	68
Number:	7
Page Range:	S. 567 - 575
Date:	2020
Publisher:	GEORG THIEME VERLAG KG
Place of Publication:	STUTTGART
ISSN:	1439-1902
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ROOT RECONSTRUCTION; SPARING OPERATION; QUALITY; INSUFFICIENCY; REPLACEMENT; ANEURYSM; SINUSES Multiple languages Cardiac & Cardiovascular Systems; Respiratory System; Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/31685