[Remodelling the aortic root by resection of the ascending aorta and non-coronary sinus in annular dilatation of the aorta and acute dissection of the descending aorta. 29 observations].
The first conservative surgical procedures of the native aortic valve in annular dilatation were performed by Yacoub and David [1, 2]. These so-called remodelling and inclusion procedures provided hope for a normal life without long-term anticoagulant therapy for patients with Marfan's syndrome, with protection from the complication of an acute dissection of the ascending aorta. The authors reported their experience in the Archives des Maladies du Coeur et des Vaisseaux in 1999, with excellent results [3]. However, a certain number of cases are encountered in which the Yacoub and David procedures cannot be performed because of the presence of a pseudo-bicuspid valve, isolated asymmetrical dilatation of the non-coronary sinus or acute dissection of the aorta without dilatation of the aortic root. In these forms, the authors have developed a technique of remodelling the aortic root with conservation of the native valve by resecting the ascending aorta and non-coronary sinus, rather than carrying out a Bentall procedure. Twenty-nine cases of this type have been treated in this way for three different indications: aneurysm of the ascending aorta with bicuspid aortic valve, aneurysm of the ascending aorta with aortic insufficiency and extension to the posterior sinus, and type A acute dissection of the aorta.
Guilmet
D
D
Service de chirurgie cardiaque, HEP La Roseraie, 120, av. de la République, 93308 Aubervilliers.
Bonnet
N
N
Vuong
P N
PN
Ghorayeb
G
G
Marnette
J M
JM
Brunet
A
A
D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000473:pathology / Q000601:surgery*; D001011:Aorta / Q000473:pathology / Q000601:surgery; D001013:Aorta, Thoracic / Q000473:pathology / Q000601:surgery; D001014:Aortic Aneurysm / Q000473:pathology / Q000601:surgery*; D001021:Aortic Valve; D013504:Cardiovascular Surgical Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve