Surgical treatment of the disease involving ascending aorta

상행 대동맥 질환의 외과적 치료

  • Published : 1994.07.01

Abstract

From February 1985 to February 1993, 18 operations were performed in 17 patients for treatment of aneurysmal disease [n=12] and/or dissection of the ascending aorta [n=6]. The ages ranged from 26 to 69 years [mean 44.3 $\pm$ 11.0 years].The proposed operations include composite graft replacement of aortic valve and ascending aorta with coronary reimplantation in 11, graft replacement of ascending aorta alone in 5, aortic valve replacement and supracoronary graft replacement in 1 and ascending aorta to abdominal aorta bypass with thromboexclusion of descending aorta in one patient. Both Bentall [n=6] and Cabrol [n=5] technique were utilized for reimplantation of coronary arteries.Concomitant replacement of aortic arch and arch vessel reconstruction was necessary in two patients. Hypothermic circulatory arrest was utilized in 6 patients. Recently, four patients were managed on warm blood continuous cardioplegia via retrograde route. There were no operative deaths. No significant postoperative complications were noted. Postoperative follow up was complete in 15 patients from 1 month to 72 months. Redo operation was necessary in one patient who had suffered from distal recurrence of dissection 5 years after successful Bentall operation. The other patients are all in excellent clinical condition. From our early experience with those 17 cases, we assume that satisfactory operative result could be achieved with a variety of surgical technique including hypothermic circulatory arrest. In addition, continuous perfusion of warm blood cardioplegia via retrograde route is supposed to be beneficial in selected cases.

Keywords

References

  1. Thorax v.23 A technique for complete replacement of the ascending aorta Bentall,H.;DeBono,A.
  2. J Thorac Cardiovasc Surg. v.48 Aortic insufficiency secondary to aneurysmal changes in the ascending aorta : Surgical management Groves,L.K.;Effler,D.B.;Haok,W.A.;Gulati,K.
  3. J Thorac Cardiovasc Surg. v.59 A safer technique for replacement of the entire ascending aorta and aortic valve Edwards,W.S.;Kerr,A.R.
  4. J Thorac Cardiovasc Surg. v.81 Complete replacement of the ascending aorta with reimplantation of the coronary arteries Cabrol,C.;Pavie,A.;Gandjbakhch,I. (et al.)
  5. J Thorac Cardiovasc Surg. v.92 Eleven year experience with composite graft replacement of the ascending aorta and aortic valve Kouchoukos,N.T.;Marchall,W.G.;Wedige-Stecher,T.A.
  6. J Thorac Cardiovasc Surg. v.86 Surgical treatment of aneurysm of the ascending aorta with aortic insufficiency: A selective approach Grey,D.P.;Ott,D.A.;Cooley,D.A.
  7. N Engl J Med v.314 Surgical treatment of aneurysms of the ascending aorta in the Marfan syndrome: Result of composite-graft repair in 50 patients Gott,V.L.;Pyertiz,R.E.;Magovern,J.G.(et al.)
  8. J Thorac Cardiovasc Surg v.91 Long-term results with total replacement of the ascending aorta and reimplantation of the coronary arteries Cabrol,C.;Pavie,A.;Mesnildrey,P.(et al.)
  9. Ann Thorac Surg v.47 Composite valve-graft replacement of aortic root using separate Dacron tube for coronary artery reattachment Coselli,J.S.;Crawford,E.S.
  10. Ann Thorac Surg v.54 Composite valve graft replacement of the proximal aorta: Comparison of techniques in 348 patients Svensson,L.G.;Crawford,E.S.;Hess,K.R.(et al.)
  11. J Thorac Cardiovasc Surg v.101 Warm Heart Surgery. Lichtenstein,S.V.;Ashe,K.A.;El Dalati H.(et al.)
  12. Ann Thorac Surg v.51 Retrograde continuous warm blood cardioplegia: A new concept in myocardial protection Salerno,T.A;.Houck,J.P.;Barrozo,C.A.(et al.)