What is the clinical evidence from this study?

Study design: Observational. Population: Aortic root aneurysm or dissection after previous ascending aorta and/or aortic valve surgery (n=34). Intervention: Redo aortic root reconstruction. Primary outcome: In-hospital mortality.

What does this research mean for the field?

Redo aortic root reconstruction in patients with prior ascending aorta or aortic valve surgery is technically demanding but can achieve favorable early outcomes with zero in-hospital mortality when performed in specialized centers. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This research aims to assess the early outcomes of aortic root reconstruction in patients with previous surgeries on the ascending aorta or aortic valve.

May 29, 2026

Early outcomes of aortic root repair after previous ascending aorta and aortic valve surgery

Key Result

Redo aortic root reconstruction after previous ascending aorta or aortic valve surgery achieved 0% in-hospital mortality, though intraoperative technical difficulties occurred in 26% of cases.

Key Points

This research aims to assess the early outcomes of aortic root reconstruction in patients with previous surgeries on the ascending aorta or aortic valve.
Retrospective single-center study involving 34 patients from 2011 to 2026 who underwent aortic root reconstruction.
Analysis of intraoperative data, procedural characteristics, and early postoperative outcomes.
Median age of patients was 54.5 years; 85% were male.
Primary reasons for redo surgery included aortic root aneurysm (50%) and combined aneurysm with residual dissection (38%).
The majority of procedures (85%) utilized the Bentall-DeBono approach, while 12% used the David procedure.
Postoperative complications included arrhythmias (6%), atrioventricular block (12%), and aortic graft infection (9%), with no in-hospital mortality.

Study Design

Type

Observational (n=34)

Multicenter

Structured PICO

Population

34 patients who underwent aortic root reconstruction after previous ascending aorta and/or aortic valve surgery. Median age 54.5, 85% male.

Intervention

Redo aortic root reconstruction (Bentall-DeBono procedure in 85% of cases, David procedure in 12% of cases; concomitant aortic arch procedures in 73%)

Outcome

Early postoperative outcomes (including in-hospital mortality, intraoperative technical difficulties, arrhythmias, atrioventricular block, and aortic graft infection)hard clinical

Redo aortic root reconstruction after previous ascending aorta or aortic valve surgery is technically demanding with notable complication rates, but can be performed with 0% in-hospital mortality in specialized centers.

Abstract

Objective. To evaluate early outcomes of aortic root reconstruction in patients with prior ascending aorta and/or aortic valve surgery. Material and methods. A retrospective single-center study included 34 patients who underwent aortic root reconstruction between 2011 and 2026 after previous ascending aorta and/or aortic valve surgery. Median of age was 54.5 (44.5; 63) years, and males comprised 85%. Previous procedures included aortic valve replacement (53%) and ascending aortic replacement (47%). Intraoperative data, procedural characteristics and early postoperative outcomes were analyzed. Results. The main indications for redo surgery were aortic root aneurysm (50%) and aneurysm combined with residual Stanford type A dissection (38%). Bentall—DeBono procedure was performed in 85% of cases, David procedure — in 12% of cases. Concomitant aortic arch procedures were required in 73% of patients, including frozen elephant trunk in 20% of patients. Median of surgery time was 336 (264; 429) min. Intraoperative technical difficulties with injury of cardiac or vascular structures occurred in 26% of patients. Early postoperative arrhythmias were observed in 6%, atrioventricular block — in 12% with permanent pacemaker implantation in 6% of cases. Aortic graft infection was diagnosed in 9% of cases. There was no in-hospital mortality. Conclusion. Redo aortic root reconstruction is a technically demanding procedure requiring individual surgical strategies. Favorable early outcomes can be achieved in specialized centers, even in cases requiring extensive aortic arch reconstruction.

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