Treatment of fusiform ascending aortic aneurysms: A comparative study with 2 options

Autor: Dan Qu, Guangyu Ji, Fanglin Lu, Ji-bin Xu, Hao Zhang, Zhiyun Xu, Lin Han
Rok vydání: 2011
Předmět:
Aortic arch
Adult
Male
Pulmonary and Respiratory Medicine
medicine.medical_specialty
China
Time Factors
Heart Valve Diseases
Kaplan-Meier Estimate
Aortography
Risk Assessment
Aortic aneurysm
Blood Vessel Prosthesis Implantation
Bicuspid aortic valve
Aortic valve replacement
Risk Factors
Aortic sinus
medicine.artery
Internal medicine
Ascending aorta
medicine
Humans
Survival rate
Aged
Proportional Hazards Models
Retrospective Studies
Heart Valve Prosthesis Implantation
Chi-Square Distribution
business.industry
Patient Selection
Perioperative
Middle Aged
medicine.disease
Surgery
Aortic Aneurysm
Survival Rate
medicine.anatomical_structure
Treatment Outcome
Aortic Valve
Cardiology
cardiovascular system
Female
business
Tomography
X-Ray Computed
Cardiology and Cardiovascular Medicine
Vascular Surgical Procedures
Zdroj: The Journal of Thoracic and Cardiovascular Surgery. 141(3):738-743
ISSN: 0022-5223
DOI: 10.1016/j.jtcvs.2010.05.031
Popis: Objective Ascending aortic replacement and reinforced reduction aortoplasty are 2 optional procedures for the treatment of fusiform ascending aneurysms. This study was designed to compare the early and late results of these 2 options. Methods Between January 2000 and January 2008, 71 patients with fusiform ascending aortic aneurysms and aortic valve disease underwent reinforced reduction aortoplasty associated with aortic valve replacement (RRA group, n = 32) or ascending aortic replacement combined with aortic valve replacement (AAR group, n = 39). Patients requiring other concomitant cardiac procedures were excluded. Perioperative events and late results were compared. Results The variables of the 2 groups were similar, except age and preoperative diameter of the ascending aorta. Despite the nearly identical perioperative morbidity in the 2 groups, mean cardiopulmonary bypass time and aortic crossclamping time were shorter in the RRA group. The follow-up period was between 1 and 8 years (mean, 3 years and 4 months). The 5-year survival rate was 90.7% ± 6.4% versus 87.0% ± 6.3%, respectively. Although there was a significant increase in aortic sinus diameters in the AAR group, all aortic sinus diameters were within the acceptable range. There was no increase in proximal aortic arch diameters in the 2 groups. Conclusions For the treatment of fusiform ascending aortic aneurysms, both procedures can result in favorable and comparable late results in appropriate patients. Furthermore, reinforced reduction aortoplasty should be encouraged more because of its significant operative simplicity and safety if only the quality of the aortic wall is acceptable.
Databáze: OpenAIRE
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