Perioperative results of the aortic root replacement in strict graft inclusion technique

Bleeding may sometimes be a serious problem after the termination of the aortic root replacement. Therefore, the strict graft inclusion technique has been developed to avoid major complications. We present the early results after aortic root replacement in strict graft inclusion technique.

The strict graft inclusion technique was performed in 28 patients between April 2001 and June 2006 in St-Johannes-Hospital-Dortmund, Dortmund, Germany. There were nine female and 19 male patients. The mean age was 57.78 +/- 12.01 years (28 to 77 years). A type A aortic dissection and an ascending aortic aneurysm with aortic valve lesion were the indication to operation in patients.

There were no early mortality and postoperative rethoracotomy. The mean postoperative bleeding over mediastinal drains was 565 +/- 310 mL. (100-2250 mL). In exception of the patients with preoperative double thrombocyte aggregation inhibitors therapy and postoperative consumption coagulopathy, the mean postoperative bleeding over mediastinal drain was 443.04 +/- 171.59 mL (100-1100) in the first 24 hours, the transfusion rate was minimal, mean 0.39 +/- 0.64 packed red blood cells (RBC) (0-4) and mean 0.14 +/- 0.27 packed fresh frozen plasma (FFP) (0-4), whereas only in 18 patients (78.26%) out of 23 patients was a transfusion not necessary. The intraoperative and postoperative requirement for substitution of erythrocyte concentrate was mean 1 +/- 1.28 packed RBC (0-5) and FFP concentrate was mean 1.21 +/- 1.90 packed FFP (0-12).

The strict graft inclusion technique for aortic root replacement represents a safe and feasible method to avoid bleeding from coronary ostial anastomoses, from aortic annular suture lines, and annular leak.