RT Journal Article
SR Electronic
T1 Surgery of the ascending aorta: five years' experience at a regional cardiac centre.
JF Thorax
JO Thorax
FD BMJ Publishing Group Ltd and British Thoracic Society
SP 599
OP 605
DO 10.1136/thx.34.5.599
VO 34
IS 5
A1 P G Reasbeck
A1 J L Monro
A1 J K Ross
A1 N Conway
A1 A M Johnson
YR 1979
UL http://thorax.bmj.com/content/34/5/599.abstract
AB Between 1972 and 1978, 31 patients underwent replacement of the ascending aorta, with or without aortic valve surgery, at the Wessex Regional Cardiac Centre. The commonest indications for operation were aneurysmal dilatation of the ascending aorta causing aortic regurgitation and acute dissection of the ascending aorta. Eleven of the 31 patients had features of Marfan's syndrome. The overall hospital mortality was 19.4%, a figure comparable with those reported in other series; ventricular failure secondary to ischaemia during operation was the commonest cause of death. The long-term symptomatic results were excellent, except in the two patients who underwent resuspension of the aortic valve for aortic regurgiation associated with acute dissections. For aneurysms of the ascending aorta with associated aortic regurgitation, replacement of the valve and ascending aorta with a combined valve prosthesis and synthetic tube graft, with reimplantation of the coronary ostia, is the procedure of choice if the aortic valve ring is diseased. Experience to date indicates that replacement of the ascending aorta and aortic valve with separate prostheses, leaving the coronary ostia undisturbed, is a satisfactory alternative provided the aortic annulus is of suitable size and quality; this is more likely to be the case in dissections than in aneurysmal dilatation of the ascending aorta. Replacement of the ascending aorta may also be indicated in some cases of dilatation of the ascending aorta secondary to aortic valve disease if the aortic wall is unusually thin.