Florida Sleeve versus Reimplantation Procedure: Mid-term Results

Dmitry S. Khvan, Alexander Chernyavskiy, Dmitry Sirota, Sergey Alsov, Maxim Lyashenko

E. Meshalkin National Medical Research Center of the Ministry of Health of the Russian Federation, Novosibirsk, Russia

Date, time and location: 2018.05.27 08:30, Congress Hall, 2F–B

Abstract

BACKGROUND

The aim of this study was to evaluate mid-term results of simplified valve-sparing aortic root reimplantation technique (Florida Sleeve) and David procedure in patients with aortic root aneurysm and concomitant aortic insufficiency.

METHODS

Prospective randomized single-blind study was conducted to compare randomly assigned patients for Florida Sleeve (FS-group) or David-I procedure (D-group). The primary end-point was increase in aortic insufficiency of grade ≥2+ at 5 years. Follow-up data were available for all patients and 100% complete.

RESULTS

There were enrolled 64 patients; 32 were assigned to FS-group and 32 to D-group. Groups did not differ preoperatively. Mean age was 56±12 years. Median aortic insufficiency was 3 (interquartile range [IQR], 2;3). CPB and aortic cross-clamping times were lower in the FS-group. There were no differences in complication events. The overall survival at 5 years was 90% for both groups (p=0.98). The overall freedom from aortic regurgitation >2+ at 5 years was 92.0% and 92.1% in Group-FS and Group-D respectively (p=0.94). Compared with those receiving David procedure, patients given Florida Sleeve procedure had a similar risk for death (hazard ratio 1.03; 95% confidence interval CI, 0.21-5.08; p=0.98) and for aortic insufficiency more than grade >2+ (hazard ratio 1.07; 95% CI, 0.13-6.79; p=0.94).

CONCLUSIONS

Among patients undergoing valve-sparing technique, there was no significant difference between those receiving Florida Sleeve or David procedurewith regard to survival or freedom from aortic insufficiency at 5 years of follow-up.