Surgical management of ascending aortic aneurysm due to non-infectious aortitis.
OBJECTIVE
We reviewed the spectrum of disease and early outcomes of patients undergoing ascending aortic surgery for Giant cell aortitis (GCA).


METHODS
Of 1 259 patients undergoing repair of ascending aortic aneurysms between January 1993 and July 2006, 100 had histologic evidence of GCA or lymphoplasmacytic aortitis.


RESULTS
Operative Mortality was 4% (4/100). One patient underwent aortoplasty and aortic valve replacement (AVR). Among 99 patients undergoing graft replacement of the ascending aorta, distal disease required hemiarch replacement in 33 and total arch replacement in 14. Proximal aneurismal disease of the root was managed by mechanical or biological root replacement (n=18), Yacoub remodeling (n=2) or David reimplantation (n=9). Another 12 patients had separate AVR and ascending graft, while 26 had AR corrected by restoration of proper sinotubular junction diameter. In total, of 63 patients with AR, 38 had a valve-preserving procedure (61%).


CONCLUSIONS
Ascending aortic aneurismal disease due to GCA is frequently associated with proximal and/or distal disease. Valve sparing procedures are technically feasible for many, although late durability is uncertain.
Mennander
Ari A
AA
Division of Cardiovascular Surgery, Mayo Clinic, 200 1st Street, Rochester 55901 MN, USA.
Miller
Dylan V
DV
Liang
Kimberly P
KP
Warrington
Kenneth J
KJ
Connolly
Heidi M
HM
Schaff
Hartzell V
HV
Sundt
Thoralf M
TM
D000368:Aged; D000369:Aged, 80 and over; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D001027:Aortography / Q000379:methods; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000401:mortality; D005240:Feasibility Studies; D005260:Female; D013700:Giant Cell Arteritis / Q000150:complications* / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome