Surgical treatment of aortic valve insufficiency due to annulo-aortic ectasia

Five cases of annulo-aortic ectasia are described: etiology was cystic medial necrosis in three, syphylitic aortitis in one and giant-cell aorto-arteritis in another. Apart from the latter patient, in whom the ascending aorta was not truly aneurysmal and aortic valve replacement and aneurysmorraphy were considered adequate, total replacement of the ascending aorta and valve was employed in every case. All patients survived without any complication related to the technique, and are completely asymptomatic 14 to 26 months after the operation. The available techniques for managing annulo-aortic ectasia are reviewed, and their merits and drawbacks discussed.