Influence of the extent of aortic replacement on survival and quality of life in patients with aortic root replacement

Abstract

　Background: The influence of the extent of aortic replacement on the aortic root replacement is unclear. We investigated the clinical outcomes of the aortic root replacement in terms of the extent of aortic replacement and evaluated quality of life (QOL) after surgery. 　Methods: Thirty six patients were enrolled in this study. The mean age was 59.0 ± 13.1 years. The 36 patients were divided into three groups according the extent of aortic replacement: 21 patients with replacement of the ascending aorta (SB), 7 patients with hemi-arch replacement (HB), and 8 patients with total aortic arch replacement (TB). Postoperative health-related QOL was evaluated by SF-36 Version 2. 　Results: The hospital mortality in the 36 patients was 2.8%. The patient (TB) died from fungal infection of the prosthetic graft. Three late deaths (8.6%) were observed: cerebral hemorrhage in one (SB), pneumonia in one (SB), and unknown in one (HB). The 5-year survival was 94.1 ± 5.7% in the SB group, 100% in the HB and 87.5 ± 11.7% in the TB groups, respectively (p=0.84). One patient (4.8%) in the SB group had an aorta-related event 7 years after surgery. No patinets had aorta-related events in both the HB and the TB groups. There was no significant difference in postoperative health-related QOL among the three groups. 　Conclusions: Aortic root replacement at our hospital achieved excellent results. Neither long-term survival nor postoperative QOL differed significantly according to the extent of aortic root replacement. We plan to extend the present study by including a larger number of subjects.