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

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.