Ascending aortic aneurysm treatment with linear plication and external wrapping technique: mid-term results

The aim of this study is to assess mid-term outcomes of reduction aortoplasty and wrapping technique which is an alternative method to replacement of the aorta in ascending aortic aneurysms. We aimed to show the efficacy of this technique especially when used for patients with increased perioperative mortality or morbidity due to their concomitant pathologies.

From March 2009 to May 2011, 22 patients underwent reduction aortoplasty and wrapping for ascending aortic aneurysm. The study group consisted of 16 male and six female patients with a mean age of 68 ± 13.1 years. Linear plication with wrapping was performed as concomitant surgery in 20 patients and as a primary procedure in two patients. The diameter of the aorta was measured using a computed tomography scan 12 months after surgery and was compared with the preoperative value.

Mean aortic clamp and cardiopulmonary bypass times were 91.0 ± 58.1 and 150.7 ± 80.9 minutes, respectively. Mortality was 9.1%. In no case was the postoperative death related to the aortoplasty procedure. The mean postoperative ascending diameter was 29.5 ± 1.04 mm (vs. preoperative 49.1 ± 4.1 mm, p < 0.001). Mean follow-up time was 17.2 ± 8.88 months. During the follow-up period we observed that there were no findings to suggest redilatation.

Linear plication with external wrapping is a therapeutic option with promising mid-term results, in carefully selected, high surgical risk patients with an ascending aortic aneurysm.