Preserved Windkessel Function in Patients Following Reduction Aortoplasty of the Ascending Aorta

Abstract

RAA without external wrapping shows good long-term results in patients with a dilated ascending aorta who underwent concomitant cardiac procedures. Echocardiography is very accurate in measuring the ascending aortic diameter, which makes it a cost-effective diagnostic tool. Moreover, ascending aortoplasty without external wrapping preserves the important elastic properties, namely the Windkessel function. Follow-up of the cardiac function and aortic diameter can be performed easily and precisely in the outpatient setting.

Effect of personalized external aortic root support on aortic root motion and distension in Marfan syndrome patients

“…In contrast to the mesh sleeve used in PEARS surgery, woven tubular Dacron grafts used in Bentall and valve sparing root replacement operations are essentially non-compliant and highly stiff without any distensibility or Windkessel effect. Tremblay et al showed that woven Dacron graft is the stiffest of all the graft materials used in aortic reconstruction with the stiffness~25 times of the normal human aorta [13] and Bail et al showed that patients with Dacron graft replacement of the aorta had a systolic change in diameter of only 0.7 mm [26].…”

Comparison of Reduction Ascending Aortoplasty and Ascending Aortic Replacement for Bicuspid Valve Related Aortopathy in Young Adult Patients Undergoing Aortic Valve Replacement—Long-Term Follow-Up

“…This has several advantages in the short and medium terms. These include avoiding the introduction of prosthetic material, shorter operative and bypass times and, as has been shown in other studies, preservation of Windkessel function [11]. Our analysis also adds long-term (mean nine years) satisfactory aortic diameters to this list.…”

“…We believe CT is a reliable and reproducible method of measuring the mid ascending aortic diameter. A recent German study, has shown trans-thoracic echocardiographic diameters correlate well with CT diameters of the mid ascending aorta [11], however ascending aortic diameters are rarely reported on routine post-operative trans-thoracic echo.…”

“…An alternative management strategy for the dilated ascending aorta is reduction ascending aortoplasty (RAA) [8][9][10][11]. The results of this technique are encouraging, however most studies have a follow-up period shorter than five years.…”

Valve-Sparing Replacement of the Aortic Root after Repair of Tetralogy of Fallot

“…Loss of Windkessel function (increased aortic stiffness) increases systolic blood pressure, leading to increased LV afterload and LV hypertrophy. 9) Further in-vitro or animal studies, as well as an observational, clinical study, will be needed to clarify the Windkessel function and LV function, in order to determine the optimal indication for surgery in patients with ascending aortic aneurysm.…”