Document Detail


Is reduction aortoplasty (with or without external wrap) an acceptable alternative to replacement of the dilated ascending aorta?
MedLine Citation:
PMID:  19602491     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Michael Gill; Joel Dunning
Publication Detail:
Type:  Journal Article; Review     Date:  2009-07-14
Journal Detail:
Title:  Interactive cardiovascular and thoracic surgery     Volume:  9     ISSN:  1569-9285     ISO Abbreviation:  Interact Cardiovasc Thorac Surg     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-09-23     Completed Date:  2009-12-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101158399     Medline TA:  Interact Cardiovasc Thorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  693-7     Citation Subset:  IM    
Affiliation:
Department of Cardio-thoracic Surgery, James Cook University Hospital, Middlesbrough, TS4 3BW, UK. m.gill@nhs.net
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MeSH Terms
Descriptor/Qualifier:
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:
Interact Cardiovasc Thorac Surg. 2009 Oct;9(4):697   [PMID:  19773240 ]

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


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