Abstract
From July 1980 to February 1984, 26 patients underwent composite replacement of ascending aortic aneurysm and aortic valve with coronary reimplantation. This group included 14 patients with dissecting aneurysm (ten and four respectively, belonging to Types I and II), and 12 patients with chronic aneurysm (six atherosclerotic aneurysms, two Marfan's syndrome and four annuloaortic ectasia cases). Hospital mortality was 35.7% (5/14) in the dissection subgroups and 16.6% (2/12) in the chronic aneurysm subgroup (difference NS). No operative risk factor was recognized. The 19 survivors have been followed up for a total of 393 patient-months (range 5 to 49 months). Controls included echocardiography and computed tomography scanning. Two patients died because of rupture of a persistently dissected aorta; another patient died of an unknown cause. Total actuarial survival rate at 4 years was 58.3 ± 10.4% (83.3 ± 10.7% for chronic aneurysms and 42.3 ± 13.4% for dissecting aneurysms). Among late survivors, there were no paravalvular leaks, new dissections, or thromboembolisms, although two perigraft hematomas and a persistent dissection were later disclosed. When appropriate, composite conduit replacement of the ascending aorta can increase the survival rate, and can also be useful in high-risk patients.
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- Anderson R. P., Bonchek L. I., Grunkemeier G. L., Lambert L. E., Starr A. The analysis and presentation of surgical results by actuarial methods. J Surg Res. 1974 Mar;16(3):224–230. doi: 10.1016/0022-4804(74)90035-3. [DOI] [PubMed] [Google Scholar]
- Bentall H., De Bono A. A technique for complete replacement of the ascending aorta. Thorax. 1968 Jul;23(4):338–339. doi: 10.1136/thx.23.4.338. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cabrol C., Gandjbakhch I., Cham B. Anévrismes de l'aorte ascendante: remplacement total avec réimplantation des artères coronaires. Nouv Presse Med. 1978 Feb 4;7(5):363–365. [PubMed] [Google Scholar]
- Cooley D. A. Annuloaortic ectasia. Ann Thorac Surg. 1979 Oct;28(4):303–304. doi: 10.1016/s0003-4975(10)63125-6. [DOI] [PubMed] [Google Scholar]
- Egloff L., Rothlin M., Kugelmeier J., Senning A., Turina M. The ascending aortic aneurysm: replacement or repair? Ann Thorac Surg. 1982 Aug;34(2):117–124. doi: 10.1016/s0003-4975(10)60871-5. [DOI] [PubMed] [Google Scholar]
- Grey D. P., Ott D. A., Cooley D. A. Surgical treatment of aneurysm of the ascending aorta with aortic insufficiency. A selective approach. J Thorac Cardiovasc Surg. 1983 Dec;86(6):864–877. [PubMed] [Google Scholar]
- Helseth H. K., Haglin J. J., Monson B. K., Wickstrom P. H. Results of composite graft replacement for aortic root aneurysms. J Thorac Cardiovasc Surg. 1980 Nov;80(5):754–759. [PubMed] [Google Scholar]
- Kouchoukos N. T., Karp R. B., Blackstone E. H., Kirklin J. W., Pacifico A. D., Zorn G. L. Replacement of the ascending aorta and aortic valve with a composite graft. Results in 86 patients. Ann Surg. 1980 Sep;192(3):403–413. doi: 10.1097/00000658-198009000-00016. [DOI] [PMC free article] [PubMed] [Google Scholar]
- McCready R. A., Pluth J. R. Surgical treatment of ascending aortic aneurysms associated with aortic valve insufficiency. Ann Thorac Surg. 1979 Oct;28(4):307–316. doi: 10.1016/s0003-4975(10)63127-x. [DOI] [PubMed] [Google Scholar]
- Miller D. C., Stinson E. B., Oyer P. E., Moreno-Cabral R. J., Reitz B. A., Rossiter S. J., Shumway N. E. Concomitant resection of ascending aortic aneurysm and replacement of the aortic valve: operative and long-term results with "conventional" techniques in ninety patients. J Thorac Cardiovasc Surg. 1980 Mar;79(3):388–401. [PubMed] [Google Scholar]
- Singh M. P., Bentall H. H. Complete replacement of the ascending aorta and the aortic valve for the treatment of aortic aneurysm. J Thorac Cardiovasc Surg. 1972 Feb;63(2):218–225. [PubMed] [Google Scholar]