Document Detail

Surgical treatment of ascending aortic pathology.
MedLine Citation:
PMID:  2980016     Owner:  NLM     Status:  MEDLINE    
Among the first 10,200 valvular replacements performed in our unit, 288 complex repairs of the ascending aorta were done for various aortic pathology. Aneurysms of the ascending aorta were the most frequent; 53 supracoronary artery aneurysms with aortic valvular insufficiency were treated by the separate replacement of the aortic valve and the supracoronary ascending aorta; 206 annulo-aortic ectasia had total and combined replacement of the ascending aorta and the aortic valve with a personal modification of the Bentall's technique using an 8-mm diameter Dacron graft to perform the reimplantation of the coronary arteries on the composite aortic grafts. The operative mortality for the first 100 patients was 4% and for the entire 206 patients, 6%. Late mortality during a follow-up period ranging from 18 months to 8 years was 11%. The actuarial survival rate at 8 years is 75%; 25 patients restudied by angiography demonstrated satisfactory results with neither stenosis nor aneurysm on the coronary graft but a recurrent or persisting chronic distal aortic dissection in four patients. In 26 cases of aortic valvular endocarditis, large abscesses of the aortic annulus involved the aortic root. In 11, the aortic repair consisted of the insertion of a subcoronary valved conduit (two early deaths, two late deaths, one reoperation, seven good results--maximum follow-up of eight years). Twelve patients had a supracoronary valved conduit with four early deaths, one late death, and two reoperations; seven are alive and well, two to six years later. Three patients previously operated had a left ventricular abdominal aorta valved conduit; two of them are alive and well up to six years later. In three patients with iterative aortic paravalvular leak (recurring three or four times), ablation of the aortic insufficiency was obtained by interposition of a composite valved graft in the ascending aorta.
C Cabrol; I Gandjbakhc; A Pavie
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of cardiac surgery     Volume:  3     ISSN:  0886-0440     ISO Abbreviation:  J Card Surg     Publication Date:  1988 Sep 
Date Detail:
Created Date:  1992-04-09     Completed Date:  1992-04-09     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8908809     Medline TA:  J Card Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  167-80     Citation Subset:  IM    
Service of Cardiovascular Surgery, Hôpital La Pitie, Paris, France.
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MeSH Terms
Abscess / surgery*
Aneurysm, Dissecting / classification,  radiography,  surgery*
Aortic Aneurysm / classification,  radiography,  surgery*
Aortic Valve*
Cardiac Surgical Procedures / methods*,  mortality,  standards
Endocarditis, Bacterial / surgery*
Follow-Up Studies
Heart Valve Diseases / surgery*
Middle Aged
Paris / epidemiology
Postoperative Complications / etiology,  mortality
Reoperation / statistics & numerical data
Survival Rate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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