[Aortic replacement with composite or separate valve grafts: early and late results]

From 1974 to March 1991, 34 patients were operated on for ascending aortic aneurysm with aortic regurgitation caused by annuloaortic ectasia (18), dissecting aneurysm (11) and so on. Twenty-one patients underwent composite valve graft replacement, 7 separate valve graft replacement, 5 aortic resuspension and graft replacement, and one aortorrhaphy and aortic valve replacement. Four of these patients required ascending aorta and arch reconstruction. Another two patients who had previous separate valve graft replacement for annulaortic ectasia and required reoperation underwent Bentall operation successfully. The 30-day survival rate was 94%. Recently, we adopted open-unwrapping and aortic button technique. As a result we achieved no homologous blood transfusion by using "Cell Saver" and autologous blood preoperative storage program in four out of five patients of Bentall operation. Late survival rate including operative death were 78% and 63% at 5 and 10 years after operation, respectively.