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Partial aortic root remodeling in case of ascending aortic aneurysms
Fabrizio Sansone1, Edoardo Zingarelli, Fabrizio Ceresa
1From the *Division of Cardiac Surgery, Papardo-Piemonte Hospital, Messina, Italy; and †Division of Cardiac Surgery, Mauriziano Umberto I Hospital, Turin, Italy.
Innovations (Philadelphia, Pa.)
|October 16, 2013
Summary
Surgical remodeling of the aortic root with selected sinus replacement effectively treats degenerative ascending aortic aneurysms (AAAs) and reduces aortic regurgitation (AR) in patients with normal aortic leaflets.
Area of Science:
- Cardiovascular Surgery
- Aortic Aneurysm Research
- Aortic Valve Disease
Background:
- Degenerative ascending aortic aneurysms (AAAs) can involve the aortic root, leading to aortic regurgitation (AR).
- Surgical intervention for AAAs often requires addressing associated aortic root pathology.
Purpose of the Study:
- To evaluate the efficacy of ascending aorta replacement combined with selective sinus replacement for degenerative AAAs.
- To assess the impact of this technique on aortic regurgitation and patient outcomes.
Main Methods:
- Thirty patients with degenerative AAA and sinotubular junction/aortic root dilatation underwent ascending aorta and selected sinus replacement.
- Procedures involved replacement of one or two sinuses of Valsalva, with varying combinations based on involvement.
Main Results:
- No hospital or late deaths were observed.
- No thromboembolic or bleeding complications occurred.
- Postoperative echocardiography showed no significant AR, and CT scans confirmed normal graft positioning.
Conclusions:
- Remodeling the sinotubular junction with selective sinus replacement is a valuable technique for degenerative AAAs.
- This approach significantly reduces AR when aortic leaflets are normal.
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