title: [Exravalvular exoprosthetic repair of the aortic root: first experience].
abstract: BACKGROUND
  Understanding the processes underlying the development of arterial insufficiency in pathology of the ascending portion of the aorta, structure and function of the aortic root became the basis for the appearance and implementation of the technique of extravalvular exoprosthetic repair of the aortic root (the Florida sleeve technique) - a new approach to valve saving procedures on the aortic root.
  
  
  METHODS
  Seven patients presenting with an aneurysm of the ascending portion of the aorta and concomitant moderate-to-pronounced portal insufficiency underwent open extravalvular exoprosthetics of the aortic root according to the Florida sleeve technique. The patients average age was 50±21.41 (range 23-71) years. Of these, four were males (57%). The accompanying diseases revealed were as follows: aortic dissection in 3 cases (2 cases with DeBackey type I and 1 case with - DeBackey type II), Marfan syndrome - 2. One patient was found to have developmental abnormality as Arteria Lusoria. Functional class of heart failure according to the NYHA classification averagely amounted to 2.3. Degree 3 arterial hypertension was revealed in three cases.
  
  
  RESULTS
  In the postoperative period the degree of aortic insufficiency decreased from the average preoperative value by the group 2.42±0.53 (prior to operation) and amounted to 0.92±0.73 (p=0.03) after surgery. Also noted was reverse remodelling of the left ventricle: a decrease in the EDV from 142.8±47.0 ml before the operation to 133.1±55.89 ml (p=0.46) thereafter. There were no cases of re-do operations for aortic insufficiency within the 30-day follow up period, with one lethal outcome during 30 days.
  
  
  CONCLUSIONS
  The operation of exoprosthetics of the aortic root demonstrated satisfactory immediate results, however there is no doubt that proper analysis of the immediate and remote outcomes would require a larger number of cases. This would make it possible to determine the feasibility and the place of this technique in surgical decision-making while treating aneurysms of the ascending portion of the aorta with accompanying aortic insufficiency and to extend the spectrum of surgical interventions in the pathology concerned.
authors.forename: A M
authors.initials: AM
authors.lastname: Cherniavskiĭ
authors.forename: S A
authors.initials: SA
authors.lastname: Al'sov
authors.forename: D S
authors.initials: DS
authors.lastname: Khvan
authors.forename: D A
authors.initials: DA
authors.lastname: Sirota
authors.forename: M M
authors.initials: MM
authors.lastname: Liashchenko
mesh_terms: D000328:Adult; D000368:Aged; D000792:Angiography; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis / Q000601:surgery*; D001021:Aortic Valve; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult