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The Journal of Thoracic and Cardiovascular Surgery, Vol 81, 309-315, Copyright © 1981 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
C Cabrol, A Pavie, I Gandjbakhch, JP Villemot, G Guiraudon, L Laughlin, P Etievent and B Cham
Thirty patients had total replacement of the ascending aorta with
reimplantation of the coronary arteries, 20 for a fusiform aneurysm of the
ascending aorta and 10 because of a dissection of the ascending aorta, of
which there were acute. All had associated aortic insufficiency. The
technique consists of implantation, within the aneurysmal sac, of a Dacron
prosthesis containing a Bjork-Shiley aortic valve. The coronary orifices
are anastomosed to the tubular Dacron prosthesis by means of a second
smaller Dacron tube. The aneurysmal pouch is then closed over the entire
appliance and a fistula between the aneurysmal sac and the right atrial
appendage is created to drain oozing from the prosthesis. The operative
mortality was 10% (three deaths) and the late mortality has been 14.8%
(four deaths). The deaths, early and late, have been confined to the first
10 cases, during which time the technique was being developed. There has
been no mortality among the last 20 patients. The 23 survivors followed for
an average of 19 1/2 months (range 6 months to 5 1/2 years) are in NYHA
Functional Class I (21) or II (two). The technical modifications utilized
in this series have simplified the operation and permit the proposal of
this technique for aneurysm involving the entire ascending aorta.
ARTICLES
Complete replacement of the ascending aorta with reimplantation of the coronary arteries: new surgical approach
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