Resultados clínicos a corto y largo plazo de los pacientes sometidos a Cirugía de Tirone David en Fundación Cardioinfantil IC, 2002-2020

Abstract

Background Aortic valve-sparing root replacement (AVSRR) has gained popularity in recent years, mostly owing to its proven safety and lack of need for anticoagulation. The aim of this study was to determine the early and late morbidity and mortality associated with AVSRR in a single institution in Latin America. Methods This is a descriptive study with a retrospective cohort of 118 patients who were submitted to Tirone David procedure between January 2002 and February 2020. Patient follow-up was done in outpatient clinic, through telephone interviews and government databases to define the free time of reoperation, valve regurgitation recurrence and event-free survival, which were analyzed using Kaplan-Meier. Results The median of age was 51 years old, 28 patients had Marfan’s syndrome, the NYHA class was ≥ II in 85%, the degree of aortic regurgitation was >2+ in 77%. The mean aortic root diameter was 56mm ± 9.6, operative mortality was 0.8%, survival at 14 years was 84% IC 95% (67-93). Echocardiographic follow-up was 78% completed and revealed a postoperative AR (aortic regurgitation) in 3.2%. Freedom from AR at 120 months was 98% IC 95% (86-99). Conclusions The aortic valve-sparing root replacement (AVSRR) is safe in this cohort, with a surgical mortality rate less than 1% and a long-term mortality freedom of 78%, similar to the evidence reported in the literature.