title: Simultaneous cusp-sparing aortic root replacement and coarctectomy with total arch replacement from the midline incision.
abstract: Four cases of simultaneous surgery for aortic root aneurysm with aortic regurgitation and coarctation of the aorta were presented. Age at surgery ranged from 18 to 37 years and all were male. All had annuloaortic ectasia and dilatation of the ascending aorta, 3 had bicuspid aortic valve and 1 had acute localized aortic dissection. Preoperative grade of aortic regurgitation was trivial in 1, moderate in 2 and severe in 1. Three had aortic valve-sparing root replacement with reimplantation technique and 1 had plication of the sinotubular junction. All patients had total arch replacement, coarctectomy and orthogonal anastomosis to the descending aorta. Antegrade cerebral perfusion was used for brain protection. All patients survived and postoperative pressure difference between the upper and lower extremities disappeared. Postoperative aortogram was satisfactory.
authors.affiliation: Division of Cardiovascular Surgery, Kobe University, Kobe, Japan yokita@med.kobe-u.ac.jp.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Okita
authors.affiliation: Sakakibara Heart Institute, Tokyo, Japan.
authors.forename: Shuichiro
authors.initials: S
authors.lastname: Takanashi
authors.affiliation: Tokushima Red Cross Hospital, Tokushima, Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Fukumura
mesh_terms: D000293:Adolescent; D000328:Adult; D000784:Aortic Dissection / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D001017:Aortic Coarctation / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D001021:Aortic Valve / Q000002:abnormalities / Q000503:physiopathology / Q000601:surgery; D001022:Aortic Valve Insufficiency / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D001027:Aortography / Q000379:methods; D000082882:Bicuspid Aortic Valve Disease; D019917:Blood Vessel Prosthesis Implantation; D006348:Cardiac Surgical Procedures; D006349:Heart Valve Diseases / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D006439:Hemodynamics; D006801:Humans; D008297:Male; D012092:Replantation; D012720:Severity of Illness Index; D056346:Sternotomy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
keywords: Annuloaortic ectasia; Aortic coarctation; Midline approach; Total arch replacement