Combined replacement of the ascending aorta and the aortic valve in 42 consecutive patients: a comparison of composite graft and conventional techniques over one year
| Autor: | Denton A. Cooley, Norman Jc, Beddermann C |
|---|---|
| Rok vydání: | 1980 |
| Předmět: |
Pulmonary and Respiratory Medicine
Aortic valve Adult Male Risk medicine.medical_specialty Adolescent Aortic Valve Insufficiency Dissection (medical) Postoperative Complications medicine.artery Internal medicine Ascending aorta Medicine Humans Cardiac skeleton Cardiac Surgical Procedures Child Aorta Aged Surgical approach business.industry Middle Aged medicine.disease Coronary Vessels Aortic Aneurysm Blood Vessel Prosthesis Coronary arteries Aortic Dissection medicine.anatomical_structure Concomitant Heart Valve Prosthesis cardiovascular system Cardiology Surgery Female Composite graft Cardiology and Cardiovascular Medicine business |
| Zdroj: | The Thoracic and cardiovascular surgeon. 28(2) |
| ISSN: | 0171-6425 |
| Popis: | During 1978, 42 consecutive patients underwent simultaneous aortic valve and ascending aorta replacement in our institution. Seventy-one percent were at low risk despite a high incidence of dissection. Twenty-nine percent were high-risk patients requiring repeat or concomitant cardiac procedures, mostly on an emergency basis. Depending on the extent of the disease at the aortic root, either of 2 surgical approaches was used: (1) conventional aortic valve and supracoronary ascending aorta replacement, with or without right coronary artery ostium reimplantation, or (2) insertion of a composite graft containing an aortic valve prosthesis, with reconstruction of both coronary arteries. Preservation of coronary ostia was possible in 85% of the patients, and composite grafts wereused in 15%. The conventional method was associated with a higher percentage of survivors. This technique was found to be satisfactory unless severe dilatation or complete destruction of the aortic annulus made composite grafting necessary. The latter technique was associated with fewer re-explorations for postoperative hemorrhage. Both procedures were equally effective, resulting in an operative mortality of 10% in uncomplicated situations. Surgery appeared to offer the only chance of survival for the high-risk group, and half of these patients were salvaged. |
| Databáze: | OpenAIRE |
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