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Partial Aortic Root Remodeling in Case of Ascending Aortic Aneurysms

Sansone, Fabrizio MD*; Zingarelli, Edoardo MD; Ceresa, Fabrizio MD*; Patanè, Francesco MD*

Innovations:Technology and Techniques in Cardiothoracic and Vascular Surgery: July/August 2013 - Volume 8 - Issue 4 - p 264–268
doi: 10.1097/IMI.0b013e3182a754b6
Original Articles

Objective In degenerative ascending aortic aneurysms (AAAs), the pathological process may extend into the aortic root, causing aortic regurgitation (AR). As often one or two sinuses are involved, ascending aorta replacement should be associated with selected sinus replacement.

Methods Thirty patients (21 men and 9 women; mean ± SD age, 70.0 ± 10.4) were operated on for ascending aorta and selected sinus replacement. All patients had degenerative AAA with sinotubular junction and partial root dilatation: one or two sinuses of Valsalva were involved. Mild to moderate-severe AR was present in all patients. The mean ± SD logistic EuroSCORE 1 was 15.4 ± 12.5. Twenty patients had ascending aorta replacement associated with noncoronary sinus replacement; 8 patients, associated with both right and noncoronary sinuses; 1 patient, associated with both left and noncoronary sinuses; and 1 patient, associated with left coronary sinus alone.

Results There were no hospital or late deaths. No thromboembolic event or bleeding complications were reported. Postoperative echocardiography did not show significant AR, and computed tomographic scanning revealed a normal positioning of the vascular graft in the ascending aorta.

Conclusions Remodeling of the sinotubular junction with selected sinus replacement in degenerative AAA is a valuable approach for aortic root remodeling, leading to a significant reduction of AR when the aortic leaflets are normal.

From the *Division of Cardiac Surgery, Papardo-Piemonte Hospital, Messina, Italy; and †Division of Cardiac Surgery, Mauriziano Umberto I Hospital, Turin, Italy.

Accepted for publication June 20, 2013.

Disclosure: The authors declare no conflicts of interest.

Address correspondence and reprint requests to Fabrizio Sansone, MD, Division of Cardiac Surgery, Papardo-Piemonte Hospital, Contrada Sperone, Messina, Italy. E-mail:

©2013 by the International Society for Minimally Invasive Cardiothoracic Surgery