[The measured resection of an aneurysm of the ascending aorta with intima-saving aortic exoprosthesis].
The aim of the study was simplification of the method of prosthetic reconstruction of the ascending aorta for its aneurysm by resection of mathematically calculated area of the aortic wall with creation of supporting prosthesis around the patient's own aorta to prevent development of the aneurysm in the future. 9 patients were operated on for the aneurysm of the ascending aorta with aortal insufficiency. 7 male patients, 2 female. Age varied from 43 to 67 years (mean age--52 years). Etiology of the disease in 7 cases was degenerative changes of the aortic wall (cystomedionecrosis--syndrome of Ertheim), atherosclerosis and lues (one case each). Diameter of the aneurysm made up to 5-8 cm. The operation consists in the preservation of the patient's own aortic wall with intima, removal of previously calculated maximally thinned aortic wall and creation of supporting synthetic frame for the aorta, taking over all the load on the aortic wall. Before the operation the diameter of the normal (DN) aorta is measured above the aneurysm, for example, at the level of brachiocephalic trunk or descending aorta. Maximal diameter of the aneurysm (da) is measured. Perimeter of the aorta subjected to resection is calculated (X) according to the formula: X = pi(da - dn). In 7 patients only this operation was performed, in two--it was combined with aorto-coronary bypass, in one case from the ascending aorta and in the other--from brachiocephalic trunk together with prosthetic reconstruction of the abdominal aorta for aneurysm with replantation of the inferior mesenteric artery into the side of the prosthesis. There were neither no complications lethal outcomes in the nearest and far-off (up to 2 years) postoperative period in all patients. The authors believe that this operation should be the method of choice in treatment of patients with aneurysm of the ascending aorta without aortal insufficiency.
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Belov
D000328:Adult; D000368:Aged; D001011:Aorta / Q000601:surgery*; D001012:Aorta, Abdominal / Q000601:surgery; D001014:Aortic Aneurysm / Q000601:surgery*; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D005112:Extracorporeal Circulation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013536:Suture Techniques; D017539:Tunica Intima / Q000601:surgery*