title: Surgical experience of ascending aorta and aortic valve replacement in patient with calcified aorta.
abstract: BACKGROUND
  The conventional method of aortic cross-clamping is very difficult and increases the risk of cerebral infarct due to embolism of the calcified aorta in these patients. Accordingly, we analyzed our experience with 11 cases of ascending aorta and aortic valve replacement with hypothermic circulatory arrest.
  
  
  METHODS
  From January 2002 to December 2009, 11 patients had ascending aorta and aortic valve replacement with hypothermic arrest at our hospital. We performed a retrospective study.
  
  
  RESULTS
  There were 5 males and 6 females, with a mean age of 68 years (range, 44 to 82 years). Eight patients had aortic stenosis, and 3 patients had aortic regurgitation. An aortic cannula was inserted into the right axillary artery in 3 patients and ascending aorta in 6 patients. Two patients with aortic regurgitation had a remote access perfusion catheter inserted though the right femoral artery. The mean cardiopulmonary bypass time was 180 minutes (range, 110 to 306 minutes) and mean hypothermic circulatory arrest time was 30 minutes (range, 20 to 48 minutes). The mean rectal temperature during hypothermic circulatory arrest was 21℃ (range, 19℃ to 23℃). No patient had any new onset of cerebral infarct or cardiovascular accident after surgery. There was no hospital mortality. Early complications occurred in 1 patient who needed reoperation due to postoperative bleeding. Late complications occurred in 1 patient who underwent a Bentall operation due to prosthetic valve endocarditis. The mean follow-up duration was 32 months (range, 1 month to 8 years) and 1 patient died suddenly due to unknown causes after 5 years.
  
  
  CONCLUSIONS
  Patients with a calcified aorta can be safely treated with a technique based on aorta and aortic valve replacement under hypothermic circulatory arrest.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Korea.
authors.forename: Suryeun
authors.initials: S
authors.lastname: Chung
authors.forename: Pyo Won
authors.initials: PW
authors.lastname: Park
authors.forename: Min Suk
authors.initials: MS
authors.lastname: Choi
authors.forename: Seong Ho
authors.initials: SH
authors.lastname: Cho
authors.forename: Ki Ick
authors.initials: KI
authors.lastname: Sung
authors.forename: Young Tak
authors.initials: YT
authors.lastname: Lee
authors.forename: Jae-Han
authors.initials: JH
authors.lastname: Jeong