Ascending aortic aneurysm resection: 15 years' experience.
Between September 1989 and June 2004, 148 consecutive patients underwent ascending aortic replacement for aneurysm or dissection. There were 130 males (88%) and 18 females (12%). Their mean age was 46.20 +/- 13.36 years. Fifty-seven patients (39%) were treated for type 1 and type 2 aortic dissection, and 91 (61%) for ascending aortic aneurysm. The Bentall procedure was performed in 81 patients (55%), the Cabrol procedure in 7 (5%), separate ascending aortic replacement and aortic valve replacement or repair was carried out in 24 (16%), and ascending aortic replacement only in 36 (24%). Hospital mortality was 4.05% (6 deaths). On univariate analysis, left ventricular ejection fraction < or = 30%, emergency surgery, contained rupture, concomitant coronary artery bypass grafting, and age > or = 65 years were risk factors for early mortality. However, on multivariate analysis, ejection fraction < or = 30% and contained rupture were the only factors significantly associated with early mortality. The long-term survival rates were 87.2% +/- 3.7% at 5 years, 78.0% +/- 5.6% at 10 years, and 60.9% +/- 9.9% at 15 years. Ascending aortic resection for aneurysm or dissection can be performed with low mortality and morbidity.
Meharwal
Zile S
ZS
Escorts Heart Institute and Research Center, Okhla Road, New Delhi 110025, India. meharwal@hotmail.com
Khanna
Surendra N
SN
Choudhary
Abhay
A
Mishra
Manisha
M
Mehta
Yatin
Y
Trehan
Naresh
N
D000328:Adult; D000784:Aortic Dissection / Q000401:mortality / Q000601:surgery*; D001011:Aorta / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000401:mortality*