Dealing with dilated ascending aorta during aortic valve replacement: advantages of conservative surgical approach

Details

Serval ID
serval:BIB_CB2002F71156
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Dealing with dilated ascending aorta during aortic valve replacement: advantages of conservative surgical approach
Journal
European Journal of Cardio-Thoracic Surgery
Author(s)
Carrel  T., von Segesser  L., Jenni  R., Gallino  A., Egloff  L., Bauer  E., Laske  A., Turina  M.
ISSN
1010-7940
Publication state
Published
Issued date
1991
Peer-reviewed
Oui
Volume
5
Number
3
Pages
137-43
Notes
Journal Article
Abstract
Five to fifteen percent of patients undergoing aortic valve replacement (AVR) will have an ascending aortic aneurysm requiring a concomitant surgical procedure. On the other hand, a dilated ascending aorta is known to be a potential source of complications after AVR. From 1972 to 1988, 2278 AVR, either isolated or combined with a second cardiac procedure, were performed in our institution. In the same time interval, a dilated ascending aorta was treated in additional 291 consecutive patients during AVR. Three different surgical options were employed: aortic remodelling and external wall support in 164 patients (56.4%), composite graft replacement in 81 patients (27.8%) and a supracoronary graft in 46 patients (15.8%). Early mortality was 4.8%. Aortic remodelling plus external wall support had the lowest early mortality (1.8%) and the best 8-year survival (89.6%). Supracoronary grafting had a higher early mortality (6.4%) and lower 8-year survival (73.2%). The results of the composite graft were least favourable: early mortality was 9.8% and 8-year survival 76.5%. The results point out the necessity for instituting the appropriate surgical procedure for a dilated ascending aorta during AVR. They show that conservative aortic surgery with preservation of endothelial lining gives excellent early and late results.
Keywords
Actuarial Analysis Adolescent Adult Aged Aorta/*pathology/*surgery Aortic Aneurysm/complications/mortality/surgery Aortic Valve/*surgery Blood Vessel Prosthesis Dilatation, Pathologic/complications/mortality/surgery Female Heart Valve Diseases/complications/surgery Humans Male Middle Aged
Pubmed
Web of science
Create date
14/02/2008 14:15
Last modification date
20/08/2019 15:45
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