title: Annulo-aortic ectasia extending to the arch: composite graft repair with circulatory arrest.
abstract: OBJECTIVE
  To examine the results of surgery performed in patients with annulo-aortic ectasia extending to the arch.
  
  
  METHODS
  Retrospective hospital record review.
  
  
  METHODS
  A Canadian teaching hospital.
  
  
  METHODS
  Five patients (mean age 57 years) had annulo-aortic ectasia with severe aortic insufficiency, a maximum aneurysmal diameter ranging from 6.5 to 13 cm at the root or ascending aortic level, and extending into the arch with a diameter of at least 5 cm at the innominate artery level. They all had reconstruction with a composite prosthetic valve and Dacron tube graft employing standard techniques of aortic root replacement as well as aortic arch reconstruction with a single bevelled anastomosis in a state of profound hypothermia and circulatory arrest.
  
  
  RESULTS
  No perioperative deaths, neurological complications nor significant cardiac complications. At a median follow-up period of 46 months all patients are alive, free from cardiovascular symptoms and show no evidence of aortic aneurysmal disease.
  
  
  CONCLUSIONS
  This safe, effective and durable repair should be applied to selected patients with annulo-aortic ectasia which extends to the arch.
authors.affiliation: Department of Surgery, St Boniface General Hospital, Winnipeg, Manitoba.
authors.forename: K P
authors.initials: KP
authors.lastname: Landolfo
authors.forename: E A
authors.initials: EA
authors.lastname: Pascoe
mesh_terms: D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods / Q000592:standards; D001013:Aorta, Thoracic; D001014:Aortic Aneurysm / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography; D001807:Blood Vessel Prosthesis / Q000592:standards*; D002170:Canada; D005500:Follow-Up Studies; D006324:Heart Arrest, Induced / Q000592:standards*; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome