Reduction aortoplasty and external wrapping for moderately sized tubular ascending aortic aneurysm with concomitant operations.
BACKGROUND
Replacement of the ascending aorta with a prosthetic graft is the preferred surgical procedure for an ascending aortic aneurysm. The choice of external wrapping of the aorta is a simple, fast, and effective method for moderately sized ascending aortic aneurysms with concomitant operations. In this study, we present the midterm results of 62 patients undergoing reduction aortoplasty with external wrapping and different cardiac procedures.


METHODS
The study group consisted of 48 male and 14 female patients with a mean age of 59.3 +/- 6.0 years. Measurement of the ascending aorta diameters was obtained at three points: before surgery, during the early postoperative period, and during the follow-up. The mean preoperative aortic diameter was 52.7 +/- 0.5 mm. In all patients, the ascending aortic aneurysm was repaired by reduction aortoplasty with external wrapping.


RESULTS
Mean follow-up time was 39.6 +/- 18.0 months. There was only one mortality (1.6%) as a result of septic multiple-organ failure and no major surgical complications in the 30-day postoperative period. Reduction aortoplasty of the ascending aorta with external wrapping resulted in a significant reduction of the ascending aorta in all patients (p = 0.000). There was an increase in the mean aortic diameter during the follow-up period (p = 0.000). Although this increase was statistically significant, all measurements of the follow-up period were still within normal range.


CONCLUSIONS
External wrapping of the aorta offers excellent results with very low mortality and morbidity, and it can be regarded as a safe and effective method for the treatment of ascending aortic aneurysm in selected patients. However, the patients should be carefully monitored for redilatation after the procedure.
Arsan
Sinan
S
Department of Cardiovascular Surgery, Marmara University School of Medicine Foundation, Academic Hospital, Atasehir, Turkey. arsans@superonline.com
Akgun
Serdar
S
Kurtoglu
Nuri
N
Yildirim
Tekin
T
Tekinsoy
Bulent
B
D001011:Aorta / Q000601:surgery; D001014:Aortic Aneurysm / Q000453:epidemiology / Q000601:surgery*; D001021:Aortic Valve / Q000601:surgery; D001807:Blood Vessel Prosthesis; D006348:Cardiac Surgical Procedures / Q000401:mortality / Q000706:statistics & numerical data*; D002423:Cause of Death; D015897:Comorbidity; D001026:Coronary Artery Bypass / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome