title: Aortic valve-sparing surgery for aortic root aneurysm.
abstract: BACKGROUND
  Replacement of the aortic valve and ascending aorta with a composite graft is the most common surgical treatment for aortic root aneurysms with or without aortic regurgitation (AR). In the early 90's reconstructive procedures of the aortic root have been described with encouraging results. This paper presents our experience with this technique.
  
  
  METHODS
  Between January 2001 and May 2003, 28 patients (25 males, 3 females, mean age 60 years) with aortic root aneurysm were treated with reimplantation of the aortic valve. Twenty-two patients had AR > 2+, 5 had Marfan syndrome, 5 had an aortic arch aneurysm, 4 had type A aortic dissection, 2 patients had associated coronary artery disease, and one had mitral valve insufficiency. The only contraindication was primitive disease of the aortic leaflets.
  
  
  RESULTS
  There was one perioperative death (type A aortic dissection) and 1 patient was discharged with mild to moderate AR requiring aortic valve replacement. The cardiopulmonary bypass and aortic cross-clamping times were 230 and 184 min respectively. No neurological events were recorded. During follow-up (mean 16.7 months, range 3-32 months) 1 patient died and one had mild AR. Freedom from reoperation and from AR at 24 months was 94 and 89% respectively. At multivariate analyses we did not find any correlation between Marfan syndrome, type A aortic dissection, grade of preoperative AR, and recurrence of AR.
  
  
  CONCLUSIONS
  In our experience, valve-sparing surgery was feasible with a low mortality and morbidity and with good early results. It should be applied to all patients requiring aortic root surgery for aortic root aneurysm, a diseased aortic valve being the only contraindication.
authors.affiliation: Department of Cardiac Surgery, G.M. Lancisi Hospital, Ancona, Italy. gdieusanio@libero.it
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Di Eusanio
authors.forename: Andrea
authors.initials: A
authors.lastname: Quarti
authors.forename: Marco
authors.initials: M
authors.lastname: Di Eusanio
authors.forename: Michele Danilo
authors.initials: MD
authors.lastname: Pierri
authors.forename: Carlo
authors.initials: C
authors.lastname: Zingaro
authors.forename: Mauro
authors.initials: M
authors.lastname: Borioni
authors.forename: Carlo
authors.initials: C
authors.lastname: Sorbara
authors.forename: Gian Piero
authors.initials: GP
authors.lastname: Piccoli
mesh_terms: D000368:Aged; D001014:Aortic Aneurysm / Q000601:surgery*; D001021:Aortic Valve / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011093:Polyethylene Terephthalates / Q000627:therapeutic use; D012092:Replantation / Q000379:methods*; D013536:Suture Techniques; D016896:Treatment Outcome
chemical_list: D011093:Polyethylene Terephthalates