title: Reduction aortoplasty with external wrapping associated with aortic valve replacement in high-risk patients.
abstract: OBJECTIVE
  To assess the midterm follow-up of reduction aortoplasty with external wrapping associated with aortic valve replacement in high risk patients.
  
  
  METHODS
  Six patients with ascending aortic aneurysm and aortic valve disease were included in this study. Four of them were male. The age ranged from 61 to 70 years (mean 65.7 years). One patient presented severe mitral valve insufficiency. All patients underwent aortic valve replacement (83.3% with aortic insufficiency and 16.7% with aortic stenosis). The inclusion criteria were: surgical aortic valve disease, ascending aortic aneurysm > 5.5 cm, EuroSCORE > 6 and age above 60 years. The ascending aortic diameter ranged from 57 to 68 mm (mean 63.7 mm). Data were analyzed by paired T test for comparison between the studied variables and P < 0.05 was considered significant.
  
  
  RESULTS
  All patients underwent reduction aortoplasty with external wrapping associated with aortic valve replacement. The postoperative hospital mortality and morbidity was 0% and 16.7% (atrial fibrillation), respectively. The mean ascending aortic diameter was 37.0 +/- 4.5mm after 6 months of follow-up (P < 0.0001, compared with the preoperative period). The actuarial survival curve after 28 months of follow-up was 100%.
  
  
  CONCLUSIONS
  Reduction ascending aortoplasty with external wrapping associated with aortic valve replacement is a safe procedure with excellent midterm results in high risk patients with ascending aortic aneurysm and aortic valve disease.
authors.affiliation: Clinicord - Goiânia, GO, Brazil. rafahaddad@hotmail.com
authors.forename: Rafael
authors.initials: R
authors.lastname: Haddad
authors.forename: Walter Vosgrau
authors.initials: WV
authors.lastname: Fagundes
authors.forename: Bruno Botelho
authors.initials: BB
authors.lastname: Pinheiro
mesh_terms: D000368:Aged; D001011:Aorta / Q000473:pathology / Q000601:surgery*; D001014:Aortic Aneurysm / Q000601:surgery*; D001021:Aortic Valve / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000601:surgery*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome