Early and Midterm Results of Cabrol Technique in the Aortic Root Replacement

Guak, Kee Oh; Choi, Kang Joo; Ryoo, Ji Yoon; Lee, Yang Haeng; Hwang, Yoon Ho; Cho, Kwang Hyun

Abstract

BACKGROUND
The purpose of this study was to analyze the early and midterm results of Cabrol technique to assist in making future decisions on a more adequate technique for repairing aortic root diseases. MATERIAL AND METHOD: From August 1993 to July 1999, we performed Cabrol technique in 18 patients ; 12 annuloaortic ectasia, 6 Stanford type A aortic dissection. Male and female ratio was 11;7, mean age was 46.9+/-12.3 years and mean follow up period was 22.5+/-21.5 months. We analysed the factors influencing postoperative complications and early mortality. The factors were old age(>60 years), high NYHA(>III), preoporative concomitant disease, urgency of operation, concomitant procedure, long pump preoperative concomitant disease, urgency of operation, concomitant procedure, long pump time(>200 minute), and hospital stay time (>30 days). RESULT: Operative mortality was 11.1%, late mortality was 11.1%, and overall mortality was 22.2%. The causes of operative death were a heart failure and an arrhythmia. The causes of late death were an acute myocardial infarction and an unknown etiology. Postoperative complications were bleeding, wound infection, toxic hepatitis, acute renal failure, and cerebral infarction. The factors influencing postoperative complications were hihg MYHA Fc(>III) (p=0.044), concomitant disease (p=0.044), long pump time(>200 minute)(p=0.015), and concomitant procedure(p=0.004). There were no significant factors influencing early mortality.
CONCLUSION
The lower postoperative bleeding rate and no complication related to tension of anastomosis after Cabrol technique warrant its consideration in patients requiring aortic root replacement, especially without feasible mobilization of coronary arteries. However, to confirm the graft thrombosis, a more detailed study including periodic angiography will be required.