Composite graft replacement of the aortic root and ascending aorta for annuloaortic ectasia

Eighteen patients with annuloaortic ectasia were surgically treated during a six year period. Cystic media-necrosis was present in 17 patients, five of them presented with Marfan syndrome. All patients received a composite graft with reversed mitral Björk-Shiley or St-Jude prosthesis and reimplantation of the coronary ostia or venous bypass grafts. Combined profound selective hypothermia and hyperkalemic cardioplegia was the preferred myocardial protection technique. There was one early postoperative and two late deaths. The fifteen survivors, with a follow-up between 6 and 72 months did not present conduit related complications and clinical results are excellent; all patients are NYHA class I (11) or II (4).