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Annulo-aortic ectasia extending to the arch: composite graft repair with circulatory arrest
1Department of Surgery, St Boniface General Hospital, Winnipeg, Manitoba.
Objective:
To examine the results of surgery performed in patients with annulo-aortic ectasia extending to the arch.
Design:
Retrospective hospital record review.
Setting:
A Canadian teaching hospital.
Patients:
Five patients (mean age 57 years) had annulo-aortic ectasia with severe aortic insufficiency, a maximum aneurysmal diameter ranging from 6.5 to 13 cm at the root or ascending aortic level, and extending into the arch with a diameter of at least 5 cm at the innominate artery level. They all had reconstruction with a composite prosthetic valve and Dacron tube graft employing standard techniques of aortic root replacement as well as aortic arch reconstruction with a single bevelled anastomosis in a state of profound hypothermia and circulatory arrest.
Main Results:
No perioperative deaths, neurological complications nor significant cardiac complications. At a median follow-up period of 46 months all patients are alive, free from cardiovascular symptoms and show no evidence of aortic aneurysmal disease.
Conclusions:
This safe, effective and durable repair should be applied to selected patients with annulo-aortic ectasia which extends to the arch.