Complete replacement of the ascending aorta and the aortic valve with coronary reimplantation

Area of Science:

• Cardiovascular Surgery
• Aortic Diseases
• Cardiac Surgery

Background:

• Cystic medial necrosis affects the aorta, increasing risks of dissection and rupture.
• Aortic root and ascending aorta pathologies require complex surgical intervention.
• Coronary artery reimplantation is a critical step in aortic root reconstruction.

Purpose of the Study:

• To evaluate the outcomes of elective aortic root and ascending aorta replacement with coronary reimplantation.
• To identify factors influencing patient survival after this complex cardiac surgery.

Main Methods:

• Retrospective analysis of 6 patients undergoing elective aortic root and ascending aorta replacement.
• Surgical technique included complete replacement of affected aortic segments.
• Coronary arteries were reimplanted to the prosthetic graft.

Main Results:

• Four out of six patients survived the procedure with stable hemodynamics.
• Postoperative follow-up showed decreased heart size in survivors.
• Two patients experienced mortality due to postoperative left ventricular failure.

Conclusions:

• Elective replacement of the aortic root and ascending aorta with coronary reimplantation can achieve favorable outcomes.
• Preoperative cardiac failure and cardiomegaly are significant predictors of survival.
• This surgical approach offers a viable option for selected patients with aortic disease.