Combined Replacement of the Ascending Aorta and the Aortic Valve in 42 Consecutive Patients: A Comparison of Composite Graft and Conventional Techniques over One Year

Beddermann, Christoph; Jc, Norman; Da, Cooley

doi:10.1055/s-2007-1022057

Cited by 10 publications

(2 citation statements)

References 3 publications

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“…The good results of the perioperative RAA are in contrast to those of replacement of the ascending aorta. Replacement of the ascending aorta has a higher perioperative mortality and morbidity [ 4 , 5 , 14 - 16 ], but is justified by the number of different indications for surgery and patient characteristics [ 13 ]. Aortoplasty is contraindicated in patients requiring aortic replacement (type A aortic dissection, Marfan syndrome, cystic medial necrosis).…”

Section: Discussionmentioning

confidence: 99%

Midterm follow up in patients with reduction ascending aortoplasty

Kiessling

Odwody

Mišković

et al. 2014

J Cardiothorac Surg

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BackgroundThe reduction ascending aortoplasty in patients with an aortic ectasia/dilatation is a common procedure during concomitant cardiac operations. Aim of the follow up study was the evaluation of possible re-dilatation and complications.MethodsFrom 1998 to 2010 124 patients (69% male; mean age 66.6 ± 12 ys) with ectasia of the ascending aortic who had no further indication for an aortic replacement, were included. The mean preoperative diameter of the ascending aorta was 4.2 ± 0.6 cm. The patients risk profile was moderate (mean EF 51% ± 11%, Euroscore 4.2 ± 2.1). To treat the dilatation of the ascending aorta, a longitudinal incision was performed and a strip of the aortic wall was resected. A reduction aortoplasty was carried out with a double-layered suture line using a 4/0 Prolene mattress suture with an additional 4/0 Prolene running suture. A follow up (rate 95%) was performed by echocardiography- and clinical examination.ResultsAll patients underwent reduction aortoplasty associated with a primary cardiac surgical procedure (AVR 63%, CABG 13%, other or combination 24%). The intrahospital mortality rate was 4%. Four aortic bleeding complications occurred. After a mean postoperative period of 57 ± 39 months, the ascending aortic diameter (3.6 ± 0.6 cm) was still significantly (P < 0.01) reduced. No postoperative aortic-related complications including aortic rupture, dissection and reoperation were observed. In 4 patients, the ascending aorta had re-dilated to the preoperative diameter.ConclusionReduction ascending aortoplasty without external wrapping is a safe procedure with acceptable midterm results in patients with asymptomatic dilatations and concomitant cardiac surgical procedures.

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Section: Discussionmentioning

confidence: 99%

Midterm follow up in patients with reduction ascending aortoplasty

Kiessling

Odwody

Mišković

et al. 2014

J Cardiothorac Surg

View full text Add to dashboard Cite

show abstract

“…The good results of the perioperative RAA are in contrast to those of replacement of the ascending aorta. Replacement of the ascending aorta has a higher perioperative mortality and morbidity [4,5,[14][15][16], but is justified by the number of different indications for surgery and patient characteristics [13]. Aortoplasty is contraindicated in patients requiring aortic replacement (type A aortic dissection, Marfan syndrome, cystic medial necrosis).…”

Section: Discussionmentioning

confidence: 99%

Mid term follow up in patients with reduction ascending aortoplasty

Kießling¹,

Odwody²,

Doss³

et al. 2012

Thorac cardiovasc Surg

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Background: The reduction ascending aortoplasty in patients with an aortic ectasia/dilatation is a common procedure during concomitant cardiac operations. Aim of the follow up study was the evaluation of possible re-dilatation and complications. Methods: From 1998 to 2010 124 patients (69% male; mean age 66.6 ± 12 ys) with ectasia of the ascending aortic who had no further indication for an aortic replacement, were included. The mean preoperative diameter of the ascending aorta was 4.2 ± 0.6 cm. The patients risk profile was moderate (mean EF 51% ± 11%, Euroscore 4.2 ± 2.1). To treat the dilatation of the ascending aorta, a longitudinal incision was performed and a strip of the aortic wall was resected. A reduction aortoplasty was carried out with a double-layered suture line using a 4/0 Prolene mattress suture with an additional 4/0 Prolene running suture. A follow up (rate 95%) was performed by echocardiography-and clinical examination. Results: All patients underwent reduction aortoplasty associated with a primary cardiac surgical procedure (AVR 63%, CABG 13%, other or combination 24%). The intrahospital mortality rate was 4%. Four aortic bleeding complications occurred. After a mean postoperative period of 57 ± 39 months, the ascending aortic diameter (3.6 ± 0.6 cm) was still significantly (P < 0.01) reduced. No postoperative aortic-related complications including aortic rupture, dissection and reoperation were observed. In 4 patients, the ascending aorta had re-dilated to the preoperative diameter. Conclusion: Reduction ascending aortoplasty without external wrapping is a safe procedure with acceptable midterm results in patients with asymptomatic dilatations and concomitant cardiac surgical procedures.

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Total repair of annulo‐aortic ectasia with composite graft and reimplantation of coronary ostia: A consecutive series of 41 patients

et al. 1985

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Replacement of the ascending aorta and the aortic valve with a composite graft, including reimplantation of the coronary ostia, was carried out in 41 consecutive patients with annulo-aortic ectasia from 1975 to 1984. Thirty-seven patients were operated on electively and 4 of these had a chronic dissection. Four patients underwent an emergency operation, 1 for a ruptured aneurysm and 3 for an acute dissection. The operative procedure was identical in each case. The aortic valve and the aneurysm were resected, the coronary ostia were dissected free, mobilized, and then implanted to the tube prosthesis. There was no hospital mortality. Re-sternotomy was done in 3 patients for excessive postoperative bleeding. Two patients required a permanent pacemaker owing to a total atrioventricular block. No pseudoaneurysms at the coronary ostia or the distal aortic anastomosis were observed at control aortography carried out in each patient 6 months after surgery. One patient died 3 months after the operation because of multiple emboli. All the other patients have been symptom free during follow-up. It is concluded that total repair using the technique described is feasible in all patients with annulo-aortic ectasia and gives good early and late results.

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Combined Replacement of the Ascending Aorta and the Aortic Valve in 42 Consecutive Patients: A Comparison of Composite Graft and Conventional Techniques over One Year

Cited by 10 publications

References 3 publications

Midterm follow up in patients with reduction ascending aortoplasty

Midterm follow up in patients with reduction ascending aortoplasty

Mid term follow up in patients with reduction ascending aortoplasty

Total repair of annulo‐aortic ectasia with composite graft and reimplantation of coronary ostia: A consecutive series of 41 patients

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