gms | German Medical Science

130. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

30.04. - 03.05.2013, München

Is combination of aortic valve replacement with replacement of the supracoronary ascending aorta sufficient for treatment of combined aortic and valvular pathologies in case of maintained sinutubular junction?

Meeting Abstract

  • Sems Tugtekin - Herzzentrum Dresden, Herzchirurgie, Dresden
  • Manuel Wilbring - Herzzentrum Dresden, Herzchirurgie, Dresden
  • Klaus Matschke - Herzzentrum Dresden, Herzchirurgie, Dresden
  • Utz Kappert - Herzzentrum Dresden, Herzchirurgie, Dresden

Deutsche Gesellschaft für Chirurgie. 130. Kongress der Deutschen Gesellschaft für Chirurgie. München, 30.04.-03.05.2013. Düsseldorf: German Medical Science GMS Publishing House; 2013. Doc13dgch636

doi: 10.3205/13dgch636, urn:nbn:de:0183-13dgch6362

Veröffentlicht: 26. April 2013

© 2013 Tugtekin et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen ( Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.



Introduction: Aortic valve pathologies in combination with dilatation of the ascending aorta and maintained sinutubular junction are frequently seen. We compared clinical and long-term results after (1) combined replacement of the aortic valve and supracoronary ascending aorta (AV SCAR) with the (2) Bentall-technique.

Material and methods: 197 consecutive patients with combined aortic valve pathology and dilatation of the ascending aorta were included. Reoperation, endocarditis, combination with CABG or other valves aswell as dissecting aneurysms were excluded. Bentall-procedure was performed in 86 cases, AV SCAR in 111 patients. Follow-up was complete with a total of 749 patient-years.

Results: Bentall-group was significantly younger (58.6±1.2 vs. 66.0±1.0 years; p<0.01), suffered less frequently from extracardiac arteropathy (67.4% vs. 82.9%; p=0.01), diabetes (8.1% vs. 18.0%; p=0.03) and renal impairment (16.3% vs. 33.3%; p<0.01). Thus, logistic euroSCORE was significantly higher in AV SCAR-patients (20.8±1.1% vs. 14.1±1.3%; p<0.01). Procedure- and x-clamp-time were significantly shorter in AV SCAR-group (p=0.05). Postoperative course and clinical morbidity concerning ventilation time, bleeding, stroke, renal failure was comparable between both groups. Hospital mortality was 2.3% for Bentall and 3.6% for AV SCAR-group (p=0.6). Overall mortality was 4.0% for Bentall and 5.4% for AV SCAR-group (p=0.7). Freedom from reoperation was 98.5% and did not differ significantly between both groups.

Conclusion: The decision for Bentall-procedure was predominatly made in younger and healthier patients. Anyhow, AV SCAR provided in the older and even worser patient group comparable results and shorter procedure-times. AV SCAR might be sufficient in patients suffering from aortic valve pathologies in combination with dilatation of the ascending aorta and maintained sinutubular junction.