The Long-Term Outcome and Quality of Life after Replacement of the Ascending Aorta †
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patient Selection
- A: Supracoronary replacement of the ascending aorta, n = 35;
- B: Wheat-, David- or Bentall-procedure; n = 86.
2.2. Data Collection
2.3. SF-36 Questionnaire
2.4. Specific Questions
2.5. Surgical Procedures and Postoperative Course
2.6. Statistical Analysis
3. Results
3.1. Baseline Characteristics
3.2. Surgical Procedures
3.3. Postoperative Outcome and Survival
3.4. QoL According to SF-36 Questionnaire
3.5. Follow-Up Questionnaire
4. Discussion
5. Conclusions
6. Limitation
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Total (n = 121) | Group A (n = 35) | Group B (n = 86) | p-Value | |
---|---|---|---|---|
Age | 62.02 ± 12.54 | 67.51 ± 9.13 | 59.78 ± 13.08 | 0.003 |
Sex | <0.001 | |||
male | 83 (68.6%) | 13 (37.1%) | 70 (81.4%) | |
female | 38 (31.4%) | 22 (62.9%) | 16 (18.6%) | |
BMI | 27.67± 5.23 | 28.91 ± 5.18 | 27.17 ± 5.20 | 0.107 |
Comorbidities | ||||
Hypertension | 94 (77.7%) | 32 (91.4%) | 62 (72.1%) | 0.021 |
Hyperlipidemia | 58 (47.9%) | 22 (63.9%) | 36 (41.9%) | 0.036 |
Diabetes mellitus | 11 (9.1%) | 5 (14.3%) | 6 (7.0%) | 0.293 |
COPD | 15 (12.4%) | 3 (8.6%) | 12 (14.0%) | 0.550 |
Smoker | 52 (43.0%) | 16 (45.7%) | 36 (41.9%) | 0.698 |
pAVD | 4 (3.3%) | 0 (0.0%) | 4 (4.7%) | 0.322 |
cAVD | 6 (5.0%) | 3 (8.6%) | 3 (3.5%) | 0.354 |
Stroke | 12 (9.9%) | 3 (8.6%) | 9 (10.5%) | 0.752 |
Atrial fibrillation (AF) | 38 (31.4%) | 12 (34.3%) | 26 (30.2%) | 0.663 |
Coronary heart disease (CAD) | 28 (23.1%) | 6 (17.1%) | 22 (25.6%) | 0.318 |
Myocardial infarction (MI) | 5 (4.1%) | 1 (2.9%) | 4 (4.7%) | 1.000 |
Former PCI/Stenting | 3 (2.5%) | 1 (2.9%) | 2 (2.3%) | 0.530 |
Chronic renal failure | 6 (5.0%) | 0 (0.0%) | 6 (7.0%) | 0.180 |
Ejection fraction | 0.532 | |||
>50% | 104 (86.0%) | 31 (88.6%) | 73 (84.9%) | |
30–50% | 14 (11.6%) | 4 (11.4%) | 10 (11.6%) | |
<30% | 3 (2.5%) | 0 (0.0%) | 3 (3.5%) | |
NYHA classification | 0.313 | |||
0 | 11 (9.1%) | 4 (11.4%) | 7 (8.1%) | |
I | 31 (25.6%) | 10 (28.6%) | 21 (24.4%) | |
II | 38 (31.4%) | 11 (31.4%) | 27 (31.4%) | |
III | 40 (33.1%) | 10 (28.6%) | 30 (34.9%) | |
IV | 1 (0.8%) | 0 (0.0%) | 1 (1.2%) | |
Former Surgeries | ||||
Cardiac surgery | 8 (6.6.%) | 4 (11.4%) | 4 (4.7%) | 0.227 |
Aortic surgery | 5 (4.1%) | 1 (2.9%) | 4 (4.7%) | 1.000 |
Scores | ||||
Euroscore II | 3.00 ± 1.57 | 2.69 ± 1.64 | 3.13 ± 1.53 | 0.040 |
Surgical Procedure | Patients n = 121 |
---|---|
Supracoronary replacement of AA | 35 (28.9%) |
Wheat | 40 (33.1%) |
Bentall | 38 (31.4%) |
David | 8 (6.6%) |
Aortic Valve Prosthesis | |
biological | 65/78 (83.3%) |
mechanical | 13/78 (16.7%) |
Total (n = 121) | Group A (n = 35) | Group B (n = 86) | p-Value | |
---|---|---|---|---|
Postoperative Complication | ||||
Stroke | 3 (2.5%) | 0 (0.0%) | 3 (3.5%) | 0.556 |
Delirium | 13 (10.7%) | 4 (11.4%) | 9 (10.5%) | 1.000 |
Pericardial effusion | 9 (7.4%) | 0 (0.0%) | 9 (10.5%) | 0.058 |
Re-thoracotomy due to bleeding | 19 (15.7%) | 0 (0.0%) | 19 (22.1%) | 0.002 |
Myocardial infarction | 1 (0.8%) | 0 (0.0%) | 1 (1.2%) | 1.000 |
Sepsis | 3 (2.5%) | 1 (2.9%) | 2 (2.3%) | 1.000 |
Pneumonia | 7 (5.8%) | 2 (5.7%) | 5 (5.8%) | 1.000 |
Respiratory failure | 16 (13.2%) | 2 (5.7%) | 14 (16.3%) | 0.148 |
Wound infection | 6 (5.0%) | 0 (0.0%) | 6 (7.0%) | 0.180 |
30-day mortality | 0 (0.0%) | 0 (0.0%) | 0 (0.0%) | - |
In hospital stay | 14.57 ± 6.78 | 12.43 ± 3.38 | 15.44 ± 7.60 | 0.124 |
ICU stay | 3.22 ± 4.63 | 2.14 ± 1.63 | 3.66 ± 5.34 | 0.125 |
Discharge | 0.421 | |||
home | 113 (93.4%) | 34 (97.1%) | 79 (91.9%) | |
rehabiltation | 4 (3.3%) | 0 (0.0%) | 4 (4.7%) | |
Other acute care hospital | 4 (3.3%) | 1 (2.9%) | 3 (3.5%) | |
Follow-up | ||||
death | 9 (7.4%) | 5 (14.3%) | 4 (4.7%) | 0.119 |
re-operation during follow-up | 2 (1.6%) | 0 (0.0%) | 2 (1.2%) | 1.000 |
Employment status | 71 (58.7%) | 13 (37.1%) | 58 (67.4%) | 0.667 |
retired | 14 (19.7%) | 2 (15.4%) | 12 (20.7%) | |
returned to work | 57 (80.3%) | 11 (84.6%) | 46 (79.3%) |
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Hamiko, M.; Jahnel, K.; Rogaczewski, J.; Schafigh, M.; Silaschi, M.; Spaeth, A.; Velten, M.; Roell, W.; Ahmad, A.E.-S.; Bakhtiary, F. The Long-Term Outcome and Quality of Life after Replacement of the Ascending Aorta. J. Clin. Med. 2023, 12, 4498. https://doi.org/10.3390/jcm12134498
Hamiko M, Jahnel K, Rogaczewski J, Schafigh M, Silaschi M, Spaeth A, Velten M, Roell W, Ahmad AE-S, Bakhtiary F. The Long-Term Outcome and Quality of Life after Replacement of the Ascending Aorta. Journal of Clinical Medicine. 2023; 12(13):4498. https://doi.org/10.3390/jcm12134498
Chicago/Turabian StyleHamiko, Marwan, Katja Jahnel, Julia Rogaczewski, Myriam Schafigh, Miriam Silaschi, Andre Spaeth, Markus Velten, Wilhelm Roell, Ali El-Sayed Ahmad, and Farhad Bakhtiary. 2023. "The Long-Term Outcome and Quality of Life after Replacement of the Ascending Aorta" Journal of Clinical Medicine 12, no. 13: 4498. https://doi.org/10.3390/jcm12134498