title: Early impact of aortic wrapping on patients undergoing aortic valve replacement with mild to moderate ascending aorta dilatation.
abstract: BACKGROUND
  The management of mild to moderate dilatation of the ascending aorta of less than 5 cm is controversial, particularly when concomitant surgical correction of aortic valve is required. We investigate the impact of a simple method of aorta reduction using Dacron graft wrapping during aortic valve replacement on the rest of the aorta.
  
  
  METHODS
  We studied 14 patients who had ascending aorta dilatation of 4-5 cm before undergoing aortic wrapping during their aortic valve replacement and compared with their post-operative imaging within a month.
  
  
  RESULTS
  The diameters of the ascending aorta wrapped with the Dacron graft were significantly reduced within 4 weeks after surgery from 44.7 +/- 2.6 to 33.6 +/- 3.9 mm (p < 0.001). This was associated with significant reduction in the diameter of rest of ascending aorta: coronary sinuses (from 37.9 +/- 4.9 mm to 33.3 +/- 6.1 mm; p < 0.001), sinotubular junction (from 33.2 +/- 4.7 mm to 30.6 +/- 4.4 mm, p = 0.02), and aortic arch (from 34.7 +/- 4.3 mm to 32.6 +/- 4.1 mm, p = 0.03).
  
  
  CONCLUSIONS
  Reduction of ascending aortic dilatation by wrapping with a Dacron graft in this preliminary study is associated with favourable early reversed aortic remodelling. This supports the hypothesis that correction of mild-moderate dilatation of the ascending aorta with Dacron wrapping at the time of aortic valve surgery may prevent the progression of the dilatation, although the long-term study on a larger population is needed to confirm its benefits.
authors.affiliation: Department of Cardiothoracic Surgery, Glenfield Hospital, Leicester, LE3 9QP, UK.
authors.forename: Keng-Leong
authors.initials: KL
authors.lastname: Ang
authors.forename: Furqan
authors.initials: F
authors.lastname: Raheel
authors.forename: Amrita
authors.initials: A
authors.lastname: Bajaj
authors.forename: Andrzej
authors.initials: A
authors.lastname: Sosnowski
authors.forename: Manuel
authors.initials: M
authors.lastname: Galiñanes
mesh_terms: D000368:Aged; D001011:Aorta; D001018:Aortic Diseases / Q000473:pathology / Q000601:surgery*; D001021:Aortic Valve / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D004108:Dilatation, Pathologic / Q000601:surgery; D005260:Female; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged