Category Ranking
98%
Total Visits
921
Avg Visit Duration
2 minutes
Citations
20
Article Abstract
Background: Transfusion in acute aortic syndromes has been studied in a limited fashion. We sought to describe contemporary transfusion practice for root replacement in acute (Stanford) type A aortic dissection.
Methods: The Society of Thoracic Surgeons Adult Cardiac Surgery Database was interrogated to identify patients who underwent primary aortic root replacement for acute (Stanford) type A aortic dissection (July 2014 to June 2017). Patients (n = 1558) were stratified by type of root replacement. Multivariate regression was used to determine those variables associated with transfusion and postoperative morbidity.
Results: Transfusion was required in 90.5% of cases (n = 1410). Operative mortality for all patients was 17.3% (261 deaths). Intraoperative red blood cell transfusion portended reduced short-term survival (odds ratio [OR] 2.00, P = .025). Massive postoperative transfusion was associated with prolonged ventilation (OR 13.47, P < .001), sepsis (OR 4.13, P < .001), and new dialysis-dependent renal failure (OR 2.43, P < .001). Women were more likely to require transfusion (OR 3.03, P < .001), as were patients who had coronary artery bypass (OR 1.57, P = .009), and those in shock (OR 2.27, P < .001). Valve-sparing aortic root replacement was associated with reduced transfusion requirements vs composite roots. Institutional case volume was not appreciably correlated with transfusion.
Conclusions: Most patients undergoing root replacement for aortic dissection require blood products. Composite root replacement is associated with a greater likelihood of transfusion than a valve-sparing operation. Transfusion independently foreshadows greater operative mortality.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.athoracsur.2022.03.068 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Management of the dissected aortic root in young patients: A propensity score-matched analysis of mechanical versus bioprosthetic aortic root replacement.
JTCVS Open
August 2025
Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, Pa.
Objective: Valve selection in acute type A aortic dissection (ATAAD) requiring aortic root replacement is challenging given the clinical acuity, unknown patient preferences, risk of surgical bleeding, and limited life expectancy. We sought to identify long-term outcomes of mechanical versus bioprosthetic aortic root replacement in young patients with ATAAD.
Methods: Retrospective review of our institution's database of ATAAD was conducted to identify patients aged 65 years and younger who underwent mechanical Bentall (mech-Bentall) or bioprosthetic Bentall (bio-Bentall) for ATAAD from 2002 to 2022.
Loeys-Dietz syndrome subtypes exhibit distinct clinical behavior and aortic cellular transcriptomic profiles.
JTCVS Open
August 2025
Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, Calif.
Objectives: Loeys-Dietz syndrome comprises genetically discrete subtypes of varying clinical severity. This study integrates longitudinal Loeys-Dietz syndrome clinical outcomes after aortic root replacement with transcriptomic analysis of aortic smooth muscle cell dysregulation to investigate mechanisms governing this subtype-specific aortic vulnerability.
Methods: Single institutional experience with aortic root replacement for nondissected aneurysm in patients with Loeys-Dietz syndrome was reviewed for midterm survival and distal aortic events (subsequent aortic intervention, aneurysm, or dissection).
Early experience with a prefabricated bioprosthetic aortic valved conduit: The first 100.
JTCVS Open
August 2025
Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minn.
Objective: To evaluate the early postoperative morbidity, mortality, and prosthetic conduit function of patients who underwent aortic root replacement using a prefabricated bioprosthetic aortic valved conduit.
Methods: Single-center retrospective review of 124 consecutive adult patients who underwent aortic root replacement with a certified prefabricated bioprosthetic aortic valved conduit from 2021 to December 2023.
Results: Indications for operation were aortic aneurysms (n = 92), endocarditis (n = 12), deterioration of prior valve prosthesis (n = 13), and aortic dissection (n = 6).
Lactobacillus Bacteremia Following Dental Instrumentation in a Patient With a Bioprosthetic Valve.
Cureus
August 2025
Internal Medicine, Ronald Reagan University of California Los Angeles Medical Center, Los Angeles, USA.
Although generally considered harmless commensals or beneficial probiotics, species can act as opportunistic pathogens under certain clinical conditions. We describe a case of high-grade bacteremia in a 59-year-old man with a history of aortic root dilation status post Bentall procedure and bioprosthetic aortic valve replacement. The suspected source was recent dental instrumentation.
View Article and Find Full Text PDFAortic Valve Replacement with Annular Patch Reconstruction for Prosthetic Valve Endocarditis after the Bentall Procedure: A Case Series.
Surg Case Rep
August 2025
Department of Cardiac and Vascular Surgery, Dokkyo Medical University School of Medicine, Shimotsugagun, Tochigi, Japan.
Introduction: Prosthetic valve endocarditis following aortic root replacement (ARR) typically necessitates redo-ARR, which involves complete graft removal, extensive aortic root dissection, and coronary reimplantation. This highly invasive procedure carries substantial surgical risk, including high operative mortality. In select high-risk patients without evidence of prosthetic graft infection, alternative surgical strategies may reduce procedural complexity and improve outcomes.
View Article and Find Full Text PDF