Midterm Outcomes of Graft Insertion Technique for Redo Aortic Root Surgery.

Purpose: This study evaluated the midterm outcomes, including adverse aortic events (AAEs), of the "graft insertion technique" (GIT) for left ventricular outflow tract (LVOT) and aortic root reconstruction.

Methods: From August 2014 to March 2024, 14 consecutive patients underwent GIT for LVOT and aortic root reconstruction. The indications for surgery were prosthetic valve endocarditis in 9 cases and noninfectious pseudoaneurysm in 5 cases. Among these patients, seven (50.0%) underwent aortic root surgery, while the other seven (50.0%) underwent aortic valve replacement alone or in combination with other procedures without aortic root surgery. Their mean EuroSCORE II was 28.8 ± 17.6.

Results: The mean total operation time was 504 ± 87 min. The mean cardiopulmonary bypass and aortic cross-clamp times were 311 ± 41 and 240 ± 45 min, respectively. Operative mortality occurred in one case (7.1%), and five patients (35.7%) died during the first year of follow-up. No surviving patients experienced recurrent endocarditis. No patients died from cardiovascular events or infections after the second year of follow-up. Furthermore, no AAEs were observed on computed tomography during the follow-up period after hospital discharge.

Conclusion: GIT is a feasible alternative for high-risk cases of redo aortic root surgery.