Surgical treatment of ascending aortic aneurysms

Abstract

Aim. To analyze surgical treatment of ascending aortic aneurysms including valve-sparing aortic root replacement and to define features affecting surgical results. Material and methods. It was analyzed surgical results in 453 patients with ascending aortic aneurysms without dissection type A who were operated from 01.01.06 to 01.10.15. There were 339 men (74.8%). 36.9% of patients had bicuspid aortic valve, 7.3% — congenital connective tissue disorders especially Marfan syndrome, 55.8% — non-family nonsyndromic thoracic aortic diseases. 24 (5.3%) patients underwent re-operation due to ascending aortic enlargement after previous surgery. Results. Hospital mortality was 2.6% (12 patients). During the same period 68 David I procedures (including 4 patients with Stanford type A aortic dissection) were performed. Hospital mortality was 2.9%. We revealed following predictors of recurrence of regurgitation: initial diameter of the fibrous ring (r=0.55), position of the coaptation point of aortic leaflets (r=–0.778), asymmetric prolapse of aortic valve leaflets (r=0.818). The introduction of team approach allowed to optimize diagnostics, determination of indications and management of patients with thoracic aortic disease at all stages of surgical and endovascular treatment, to get good, reproducible results and to receive basic information about aortopathy pathogenesis.