[Surgical treatment of ascending aorta aneurysm combined with aortic valve insufficiency]

The article deals with the immediate and late-term results of surgical management of aneurysm of the ascending aorta with aortic incompetence in 33 patients, on whom 34 operations were conducted. The etiology, diagnosis of the disease, and the main moments of the surgical techniques are discussed. For the solution of surgical problems, setting apart patients with dyshistogenetic predisposition is suggested. Among the instrumental methods of examination preference was given to radiocontrast aortography and magneto-resonance tomography. The last named is preferable because it is noninvasive, highly informative, and specific. The choice of the method was determined by the existence of stratification and the level of the orifices of the coronary arteries above the fibrous ring. The conduit was wrapped in the remnants of the aneurysmatic sac in all cases; the approach to the formation of the communication between the last named and the right atrium was differentiated. The central moment of the reconstruction is the formation of the distal anastomosis of the conduit with the aorta in stratification. In the late-term postoperative periods particular attention was paid to patients with dyshistogenetic predisposition because of the possible spreading of stratification to the distal parts of the aorta.