Aneurysm of the ascending aorta
Pressl, F.; Hartl, P.; Gross, C.; Mayr, R.; Brücke, P.
Wiener Medizinische Wochenschrift 140(5): 121-124
1990
ISSN/ISBN: 0043-5341 PMID: 2346021 Document Number: 362261
Between January 1983 and March 1988 25 patients with aneurysms of the ascending aorta were operated, out of these only 15 (56%) electively. Acute incompetence (10) were the main indications for operation. Poststenotic aneurysms (2), mycotic (2) and saccular sclerotic (1) aneurysms have also been observed. A rare case of a ruptured ascending aorta due to histologically and serologically proven Brucellosis is presented. Valved conduits were used in 16 patients to reconstruct the aortic root, whereas the remaining patients had different types of supra-coronary reconstruction, i.e. resection with or without graft insertion (6 and 3 respectively). We lost 6 patients out of 25 during or immediately after operation. All of them were operated in an acute state of rupture or dissection with left heart failure, some of them already presenting neurologic deficits preoperatively. Operative and hospital mortality in 14 patients operated electively was 0%. Bentall's operation using valved conduits is a safe operation in elective patients with a reasonable mortality rate worldwide. Clinical follow up should include ultrasound studies of the operative site the remaining aorta, i.v. DSA and CT of NMR scanning in 6-12 month intervals in order to detect late complications as false or dissecting aneurysms.