| Is reduction aortoplasty (with or without external wrap) an acceptable alternative to replacement of the dilated ascending aorta? | |
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MedLine Citation:
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PMID: 19602491 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether reduction aortoplasty is an acceptable alternative to ascending aorta replacement. From 925 potential papers, 13 papers represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. We conclude that aortoplasty seems to be a safe procedure which gives good postoperative outcomes in selected patients. Our literature review documents 716 patients from 13 papers, with only 25 patients that on follow-up suffered redilatation (3%). Thus, reduction aortoplasty is a viable alternative to conventional aortic root replacement or interposition tube grafting in some patients. In particular, an aortoplasty in elderly patients with post-stenotic dilatation, or in patients with significant co-morbidities is attractive. It should be acknowledged that only one study directly compares the technique with conventional replacement and that replacement remains the 'gold standard' technique. It should also be acknowledged that the external wrap is not without risk and wrap dislocation, erosion or fistula formation are recognised complications. |
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Authors:
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Michael Gill; Joel Dunning |
Publication Detail:
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Type: Journal Article; Review Date: 2009-07-14 |
Journal Detail:
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Title: Interactive cardiovascular and thoracic surgery Volume: 9 ISSN: 1569-9285 ISO Abbreviation: Interact Cardiovasc Thorac Surg Publication Date: 2009 Oct |
Date Detail:
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Created Date: 2009-09-23 Completed Date: 2009-12-02 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101158399 Medline TA: Interact Cardiovasc Thorac Surg Country: England |
Other Details:
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Languages: eng Pagination: 693-7 Citation Subset: IM |
Affiliation:
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Department of Cardio-thoracic Surgery, James Cook University Hospital, Middlesbrough, TS4 3BW, UK. m.gill@nhs.net |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aortic Aneurysm / complications, pathology, surgery* Aortic Rupture / etiology, pathology, prevention & control* Benchmarking Blood Vessel Prosthesis Implantation* / adverse effects Evidence-Based Medicine Humans Middle Aged Patient Selection Risk Assessment Risk Factors Treatment Outcome Vascular Surgical Procedures* / adverse effects |
| Comments/Corrections | |
Comment In:
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Interact Cardiovasc Thorac Surg. 2009 Oct;9(4):697
[PMID:
19773240
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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