DEALING WITH DILATED ASCENDING AORTA DURING AORTIC-VALVE REPLACEMENT - ADVANTAGES OF CONSERVATIVE SURGICAL APPROACH

被引：69

作者：

CARREL, T

VONSEGESSER, L

JENNI, R

GALLINO, A

EGLOFF, L

BAUER, E

LASKE, A

TURINA, M

机构：

[1] Clinic for Cardiovascular Surgery, Zurich

[2] Department of Medicine, University Hospital, Zurich

来源：

EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY | 1991年 / 5卷 / 03期

关键词：

AORTIC VALVE REPLACEMENT; DILATED ASCENDING AORTA; CONSERVATIVE SURGICAL APPROACH;

D O I：

10.1016/1010-7940(91)90212-3

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Five to fifteen percent of patients undergoing aortic valve replacement (AVR) will have an ascending aortic aneurysm requiring a concomitant surgical procedure. On the other hand, a dilated ascending aorta is known to be a potential source of complications after AVR. From 1972 to 1988, 2278 AVR, either isolated or combined with a second cardiac procedure, were performed in our institution. In the same time interval, a dilated ascending aorta was treated in additional 291 consecutive patients during AVR. Three different surgical options were employed: aortic remodelling and external wall support in 164 patients (56.4%), composite graft replacement in 81 patients (27.8%) and a supracoronary graft in 46 patients (15.8%). Early mortality was 4.8%. Aortic remodelling plus external wall support had the lowest early mortality (1.8%) and the best 8-year survival (89.6%). Supracoronary grafting had a higher early mortality (6.4%) and lower 8-year survival (73.2%). The results of the composite graft were least favourable: early mortality was 9.8% and 8-year survival 76.5%. The results point out the necessity for instituting the appropriate surgical procedure for a dilated ascending aorta during AVR. They show that conservative aortic surgery with preservation of endothelial lining gives excellent early and late results.

引用

页码：137 / 143

页数：7

共 26 条

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