The replacement of the ascending aorta and aortic valve with a new design composite graft: a six-year experience.
The problems encountered in coronary artery reattachment when the ascending aorta and aortic valve are replaced with a composite graft induced Gallucci and one of the authors to develop a new aortovalvular prosthesis in clinical practice. The unique transverse ovoidal shape of this graft is intended to conform to the natural aortic root and facilitate the coronary anastomoses and minimize bleeding. We present our 6-year experience with 56 patients operated upon with this prosthesis. In all patients we were able to connect the coronary arteries directly to the graft without complications including hemorrhage or distortion of the coronary ostia. The survivors were evaluated with chest X ray, two-dimensional echocardiography, and conventional or digital subtraction angiography to detect the presence of pseudoaneurysms at the site of the coronary anastomosis, reported by others that have used the composite graft technique. The notable absence of this complication in our patients at a mean follow-up of 41 months (range 3-71) documents that this ovoidal composite graft is a reliable tool in the treatment of aortic root pathology.
Rocco
F
F
Department of Cardiac Surgery, Treviso Regional Hospital, Italy.
Cesari
F
F
Zussa
C
C
Salvador
L
L
Valfre
C
C
D001011:Aorta / Q000601:surgery*; D001021:Aortic Valve / Q000601:surgery*; D001807:Blood Vessel Prosthesis / Q000592:standards*; D006348:Cardiac Surgical Procedures / Q000379:methods / Q000401:mortality / Q000592:standards*; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis / Q000592:standards*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology; D011474:Prosthesis Design / Q000592:standards*; D011475:Prosthesis Failure; D015996:Survival Rate; D013536:Suture Techniques