title: Replacement of the ascending aorta for severe atherosclerosis during coronary artery bypass surgery.
abstract: OBJECTIVE
  In the present study, we investigated the benefit of ascending aorta replacement in patients with severe aortic atherosclerosis who undergo coronary artery bypass surgery (CABG).
  
  
  METHODS
  From January 2001 to April 2011, 3842 patients underwent CABG and in 36 of these patients (31 male, 5 female) the ascending aorta was replaced due to severe atherosclerosis. Total circulatory arrest was used in 22 patients (61%). The patients were followed for 69 ± 36 months (1-133 months) and compared to a control group of patients. The control group consisted of patients who underwent CABG with or without a concomitant procedure (n = 3806).
  
  
  RESULTS
  For the study group, the mean additive and logistic Euroscores of the patients were nine and 20, respectively. One stroke (2.8%) was observed and this patient died in the early postoperative period. There were a total of four confirmed deaths (12%) at any time point over the length of the follow-up among the patients who were discharged from the hospital. Two of them died of malignancy (lung and gastric tumors) and the other two from cardiac reasons. No patients had a stroke during follow-up. For the control group the mean age was 61 ± 1, the stroke rate was 0.6%, and the mortality rate was 0.96%, and the mean logistic and additive Euroscores were 3.7 ± 4.4, and 3.5 ± 2.5, respectively.
  
  
  CONCLUSIONS
  Replacement of highly calcified ascending aortas during CABG can be safely performed in selected patients with good long-term outcomes.
authors.affiliation: Acibadem University, Department of Cardiovascular Surgery, Istanbul, Turkey. aumitgullu@yahoo.com
authors.forename: Ahmet Umit
authors.initials: AU
authors.lastname: Gullu
authors.forename: Eyup Murat
authors.initials: EM
authors.lastname: Okten
authors.forename: Mehmet Hakan
authors.initials: MH
authors.lastname: Akay
authors.forename: Sahin
authors.initials: S
authors.lastname: Senay
authors.forename: Muharrem
authors.initials: M
authors.lastname: Kocyigit
authors.forename: Fevzi
authors.initials: F
authors.lastname: Toraman
authors.forename: E Hasan
authors.initials: EH
authors.lastname: Karabulut
authors.forename: Cem
authors.initials: C
authors.lastname: Alhan
mesh_terms: D001011:Aorta / Q000473:pathology / Q000601:surgery*; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods* / Q000401:mortality; D016022:Case-Control Studies; D003131:Combined Modality Therapy; D001026:Coronary Artery Bypass / Q000379:methods* / Q000401:mortality; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality / Q000503:physiopathology; D011859:Radiography; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D014421:Turkey