Intraoperative conversion after surgical failure: an overlooked complication of aortic root replacement in Marfan patients?
Year: 2011
Type: article
Abstract: In the context of aortic root replacement, intraoperative conversion is defined as a change of operative technique from aortic valve-sparing (AVS) to aortic valve-replacing (AVR) root replacement, or as a change from one AVR prosthesis to another during the same operation. Although intraoperative conversion represents an important form of nonstructural valve dysfunction, a valve-related complication, it is rarely reported in publications that discuss aortic root replacement.1–4
Of the 28 publications on aortic root replacement that were reviewed in a 2009 best-evidence topic5 and in a 2011 meta-analysis6 of retrospective studies, only 1 article, by Birks and colleagues,4 briefly described intraoperative conversion. That group reported 6 intraoperative conversion cases (7%) in a series of 88 patients who underwent a Yacoub remodeling AVS root replacement as the initial procedure; they excluded these cases from their analysis of operative outcomes.4 A 2011 publication by Oka and colleagues3 reported 3 cases of intraoperative conversion to AVR root replacement (3%) in a series of 101 patients who underwent AVS root replacement as their initial procedure. In all 3 cases, conversion was necessitated by cusp prolapse. In the Aortic Valve Operative Outcomes in Marfan Patients (AVOOMP),1 an international prospective registry, 316 patients underwent AVS or AVR aortic root replacement; there were 6 cases of intraoperative conversion (2%). Here, we review these cases and suggest possible explanations for the paucity of intraoperative conversion reports in the literature.
Source: PubMed Central
Institution: Baylor College of Medicine
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W21316695