title: [Replacement of the ascending aorta and aortic valve with a composite graft using a reversed St. Jude medical mitral valve prosthesis].
abstract: Between 1981 and 1989, ten patients underwent replacement of the ascending aorta and aortic valve by a composite graft for an aneurysm of the ascending aorta with aortic regurgitation. The first two cases using an SJM aortic valve prosthesis and Teflon felt-pledgeted mattress sutures for the proximal anastomoses required a coronary bypass graft from the tube graft to the anterior descending coronary artery because of difficulty in completing the graft-left coronary ostial anastomoses. In the subsequent seven cases, an SJM mitral valve prosthesis with a large, soft cuff for a valved conduit was sewn in reverse and a thin wall Teflon roll was used for the Teflon felt of the pledgeted mattress suture in the proximal anastomoses. As a result, anastomoses between the tube graft and coronary ostia were performed easily and successfully in eight patients. One case with Marfan syndrome required reoperation nine years after the first operation for recurrence of the aneurysm of the aortic arch. Thus, the need for careful and continued follow-up is important in the Marfan syndrome.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Kawasaki Medical School.
authors.forename: T
authors.initials: T
authors.lastname: Fujiwara
authors.forename: S
authors.initials: S
authors.lastname: Dokoh
authors.forename: H
authors.initials: H
authors.lastname: Inada
authors.forename: H
authors.initials: H
authors.lastname: Masaki
authors.forename: A
authors.initials: A
authors.lastname: Nogami
authors.forename: H
authors.initials: H
authors.lastname: Yamane
authors.forename: H
authors.initials: H
authors.lastname: Yoshida
authors.forename: I
authors.initials: I
authors.lastname: Morita
authors.forename: T
authors.initials: T
authors.lastname: Miyake
authors.forename: Y
authors.initials: Y
authors.lastname: Fukuhiro
mesh_terms: D001014:Aortic Aneurysm / Q000150:complications / Q000453:epidemiology / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000150:complications / Q000453:epidemiology / Q000601:surgery*; D001807:Blood Vessel Prosthesis / Q000295:instrumentation*; D006350:Heart Valve Prosthesis / Q000295:instrumentation*; D007564:Japan / Q000453:epidemiology; D012189:Retrospective Studies