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Selected therapy for ascending aortic aneurysms

C D Campbell, R L Hardesty, R D Siewers

    Archives of Surgery (Chicago, Ill. : 1960)
    |November 1, 1978
    PubMed
    Summary
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    Surgical repair of ascending aortic aneurysms with aortic insufficiency offers good outcomes. Procedures vary based on patient condition, with composite grafts for Marfan syndrome and bicuspidization for selected annulaortic ectasia cases.

    Area of Science:

    • Cardiovascular Surgery
    • Aortic Disease Management

    Background:

    • Ascending aortic aneurysms with aortic insufficiency pose significant surgical challenges.
    • Underlying etiologies include Marfan syndrome, cystic medial necrosis, aortitis, and atherosclerosis.

    Purpose of the Study:

    • To evaluate surgical repair outcomes for ascending aortic aneurysms with concomitant aortic insufficiency.
    • To compare different surgical techniques based on specific patient pathologies.

    Main Methods:

    • Review of ten patients undergoing ascending aortic aneurysm repair with aortic insufficiency since 1971.
    • Analysis of patient diagnoses, surgical procedures, and follow-up data.
    • Comparison of composite graft conduits versus valve bicuspidization techniques.

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    Main Results:

    • One operative death occurred among ten patients.
    • Follow-up exceeded seven years, demonstrating long-term viability of repairs.
    • Composite graft conduits with coronary reimplantation are preferred for Marfan syndrome.
    • Valve bicuspidization is suitable for selected annulaortic ectasia cases, avoiding anticoagulation risks.

    Conclusions:

    • Surgical repair of ascending aortic aneurysms with aortic insufficiency is effective.
    • Tailoring the surgical approach to the underlying pathology (e.g., Marfan syndrome vs. annulaortic ectasia) optimizes outcomes.
    • Bicuspidization offers an alternative to composite grafts, preserving coronary anatomy and avoiding anticoagulation.