title: Drawback of aortoplasty for aneurysm of the ascending aorta associated with aortic valve disease.
abstract: BACKGROUND
  Aortoplasty has been advocated for moderate dilatation of the ascending aorta associated with aortic valve disease. We report our results with this conservative approach.
  
  
  METHODS
  Seventeen consecutive patients with unsupported aortoplasty were reviewed. Twelve patients had aortic valve regurgitation and 5 had stenosis. The aortic wall was analyzed histologically in 14 patients. Follow-up was complete, with a mean time of 6 years (range, 2.3 to 10.5 years).
  
  
  RESULTS
  Two patients among the 15 hospital survivors died during follow-up of causes unrelated to aortic pathology. Survival at 7 years was 86.7% (+/- 8.8%). Recurring aortic aneurysms developed in 4 patients after a mean time of 63 months, with an event-free survival at 7 years of 41% (+/- 21%). All of these 4 patients had aortic valve regurgitation and cystic medial necrosis.
  
  
  CONCLUSIONS
  The recurrence rate of aneurysms after unsupported aortoplasty and aortic valve replacement is high in patients with aortic regurgitation. This strongly suggests that in these patients, the aortic dilatation is related to an underlying wall deficiency, associated with the aortic valve pathology, rather than to the hemodynamic stress imposed by the aortic valve disease.
authors.affiliation: Department of Cardiovascular Surgery, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
authors.forename: X M
authors.initials: XM
authors.lastname: Mueller
authors.forename: H T
authors.initials: HT
authors.lastname: Tevaearai
authors.forename: C Y
authors.initials: CY
authors.lastname: Genton
authors.forename: M
authors.initials: M
authors.lastname: Hurni
authors.forename: P
authors.initials: P
authors.lastname: Ruchat
authors.forename: A P
authors.initials: AP
authors.lastname: Fischer
authors.forename: F
authors.initials: F
authors.lastname: Stumpe
authors.forename: L K
authors.initials: LK
authors.lastname: von Segesser
mesh_terms: D000206:Actuarial Analysis; D000368:Aged; D001011:Aorta / Q000601:surgery; D001014:Aortic Aneurysm / Q000150:complications* / Q000401:mortality / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000150:complications* / Q000401:mortality / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000150:complications* / Q000401:mortality / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D012008:Recurrence; D013997:Time Factors