[Application and results of Robicsek procedure for dilated ascending aorta associated with aortic valve disease]

To introduce the Robicsek procedure and summarize its short to mid-term results for patients with dilatation of the ascending aorta associated with aortic valve disease.

From December 2002 to June 2006, 30 patients with a moderately dilated ascending aorta [mean diameter, (46.7+/-3.1) mm] underwent concomitant aortic valve replacement (AVR) or repairing and reinforced aortoplasty with a well-tailored Dacron vascular graft. Follow-up was obtained on all patients with ultrasonic cardiography (UCG) or computed tomography (CT) scan and was (18.0+/-10.5) months.

The total average cardio-pulmonary bypass (CPB) time was (103.4+/-21.7) min (80-151 min), and aortic arrest time was (73.0+/-21.6) min (48-120 min), whereas the average CPB time and aortic arrest time of 19 patients who underwent the isolated Robicsek procedure were only (91.3+/-8.9) min (80-118 min) and (61.6+/-11.3) min (48-82 min). No mortality occurred in the hospital. During follow-up of 18 months, no recurrent ascending aortic dilatation and dissection were observed, and the average aortic diameter was reduced to (33.7+/-2.5) mm. Sixteen of the 30 patients were diagnosed as bicuspid aortic valve (BAV). The ascending aortic media were histologically abnormal in 23 patients.

Considering the underlying wall deficiency and the homodynamic stress, the Robicsek operation should be an optimal choice to those patients with a mild to moderate dilated ascending aorta caused by aortic valve lesion. Compared with the Bentall and David procedures, the Robicsek procedure could achieve the same or even better clinical results with less operative time and risks.