[An evaluation of aortic root reconstruction using Carrel patch method with coronary anastomosis]

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Aortic Surgery

Background:

• Aortic root diseases, including annulo-aortic ectasia (AAE), root aneurysms, and aortic dissection, often require complex surgical reconstruction.
• The Carrel patch method is a reconstructive technique for the aortic root, involving reimplantation of coronary arteries into a composite graft.

Purpose of the Study:

• To evaluate the efficacy and safety of the Carrel patch method for aortic root reconstruction in patients with diverse aortic pathologies.
• To assess the incidence of complications such as pseudoaneurysm formation and long-term survival rates.

Main Methods:

• A retrospective review of 12 patients undergoing aortic root reconstruction with the Carrel patch method between January 1991 and December 1994.
• The procedure involved resection of the aortic valve and root, mobilization and reimplantation of coronary ostia to a composite graft, and coronary anastomosis using mattress sutures with Teflon felt strips.

Main Results:

• The study included patients with annulo-aortic ectasia, root aneurysm with aortic regurgitation, and aortic dissection with aortic regurgitation.
• One patient required coronary artery bypass grafting due to myocardial ischemia from coronary ostial stenosis.
• The overall mortality rate was low (1/12), with the death occurring 25 days postoperatively due to cardiac tamponade after emergency surgery for aortic dissection. No hospital deaths or pseudoaneurysms of coronary ostia were observed during an average follow-up of 25 months. Late tamponade occurred in one case.

Conclusions:

• The Carrel patch method is a feasible and effective surgical option for aortic root reconstruction across various anatomical variations and pathologies.
• The technique is associated with a low incidence of pseudoaneurysm formation and favorable long-term survival outcomes.