P238. Outcomes After Concomitant Aorta Replacement with Rapid Deployment Aortic Valve Replacement in Aortic Dilation (4.0-4.5cm)

Yoonjin Kang Poster Presenter
Seoul National University Hospital
Seoul, Seoul 
South Korea
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Assistant Professor, Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital

Thursday, April 25, 2024: 5:38 PM - 7:00 PM
Sheraton Times Square 
Room: Central Park 

Description

Objective: The optimal diameter at which concomitant aorta replacement should be done in borderline aortic dilation is not yet known. The purpose of this study was to evaluate the surgical outcomes of concomitant aorta replacement with rapid deployment aortic valve replacement (RDAVR) in borderline aortic dilation.
Methods: From September 2016 to June 2023, overall 124 patients underwent RDAVR with concomitant ascending aorta replacement due to borderline aorta dilation (4.0-4.5cm). Early outcomes including operative mortality and postoperative complication and mid-term outcomes including overall survival and freedom from aorta related events were evaluated. Multivariable analysis was performed to find the risk factors for mid-term all-cause mortality.
Results: Mean aorta diameter was 43.1± 4.0mm. Cardiopulmonary bypass time and aorta cross clamp time were 175± 44 and 126 ± 34 minutes, respectively. There was no operative mortality. The most common complication after operation was postoperative atrial fibrillation (N=51, 41.1%), followed by acute kidney injury (N=3, 12.9%). Median follow up duration was 27.8 ± 21.9 months. Overall survival at 1 year and 5 years were 98.3% and 98.3%, respectively. There were no aortic re-intervention during follow up. Multivariate analysis showed that risk factor associated with midterm all-cause mortality were COPD (HR 24.02 [2.177-265.000], P=0.009) and EuroScore (1.154 [1.067-1.247]. P<0.001).
Conclusions: Concomitant replacement of ascending aorta with RDAVR is a safe option in borderline aorta dilation.

Authors
Yoonjin Kang (1), Kyung Hwan Kim (1), Ji Seong Kim (2), Suk Ho Sohn (3), Jae Woong Choi (3)
Institutions
(1) Seoul National University Hospital, Seoul, Seoul, (2) Seoul National University Hospital, Seoul, Kyeongi-Do, (3) Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, Korea, Seoul, NA

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