title: Midterm follow up in patients with reduction ascending aortoplasty.
abstract: BACKGROUND
  The reduction ascending aortoplasty in patients with an aortic ectasia/dilatation is a common procedure during concomitant cardiac operations. Aim of the follow up study was the evaluation of possible re-dilatation and complications.
  
  
  METHODS
  From 1998 to 2010 124 patients (69% male; mean age 66.6 ± 12 ys) with ectasia of the ascending aortic who had no further indication for an aortic replacement, were included. The mean preoperative diameter of the ascending aorta was 4.2 ± 0.6 cm. The patients risk profile was moderate (mean EF 51% ± 11%, Euroscore 4.2 ± 2.1). To treat the dilatation of the ascending aorta, a longitudinal incision was performed and a strip of the aortic wall was resected. A reduction aortoplasty was carried out with a double-layered suture line using a 4/0 Prolene mattress suture with an additional 4/0 Prolene running suture. A follow up (rate 95%) was performed by echocardiography- and clinical examination.
  
  
  RESULTS
  All patients underwent reduction aortoplasty associated with a primary cardiac surgical procedure (AVR 63%, CABG 13%, other or combination 24%). The intrahospital mortality rate was 4%. Four aortic bleeding complications occurred. After a mean postoperative period of 57 ± 39 months, the ascending aortic diameter (3.6 ± 0.6 cm) was still significantly (P < 0.01) reduced. No postoperative aortic-related complications including aortic rupture, dissection and reoperation were observed. In 4 patients, the ascending aorta had re-dilated to the preoperative diameter.
  
  
  CONCLUSIONS
  Reduction ascending aortoplasty without external wrapping is a safe procedure with acceptable midterm results in patients with asymptomatic dilatations and concomitant cardiac surgical procedures.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Johann Wolfgang Goethe University, Theodor Stern Kai 7, Frankfurt am Main 60590, Germany. cardiac.surgeon@dr-kiessling.com.
authors.forename: Arndt H
authors.initials: AH
authors.lastname: Kiessling
authors.forename: Eva
authors.initials: E
authors.lastname: Odwody
authors.forename: Alexandra
authors.initials: A
authors.lastname: Miskovic
authors.forename: Ulrich A
authors.initials: UA
authors.lastname: Stock
authors.forename: Andreas
authors.initials: A
authors.lastname: Zierer
authors.forename: Anton
authors.initials: A
authors.lastname: Moritz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta / Q000601:surgery*; D001014:Aortic Aneurysm / Q000601:surgery*; D004108:Dilatation, Pathologic; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000601:surgery; D012008:Recurrence; D012086:Reoperation; D016019:Survival Analysis; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects; D055815:Young Adult