Reduction ascending aortoplasty in adult patients undergoing aortic valve replacement: Aorta diameter change, mid- and long-term clinical results / 中国胸心血管外科临床杂志

ABSTRACT

@#Objective    To assess mid- and long-term outcomes and share our clinical method of reduction ascending aortoplasty (RAA) in adult patients undergoing aortic valve replacement (AVR). Methods    We retrospectively analyzed clinical data of 41 adult patients with aortic valve disease and ascending aortic dilatation before and after operation of RAA+AVR in Fuwai Hospital from January 2010 to July 2017. There were 28 male and 13 female patients aged 28-76 (53.34±12.06) years. Twenty-three patients received AVR+RAA using the sandwich technique (a sandwich technique group), while other 18 patients received AVR+ascending aorta wrap (a wrapping technique group). Ascending aorta diameter (AAD) was measured by echocardiography or CT scan preoperatively and postoperatively. Results    There was no perioperative death. The mean preoperative AAD in the sandwich technique group and the wrapping technique group (47.04±3.44 mm vs. 46.67±2.83 mm, P=0.709) was not statistically different. The mean postoperative AAD (35.87±3.81 mm vs. 35.50±5.67 mm, P=0.804), and the mean AAD at the end of follow-up (41.26±6.54 mm vs. 38.28±4.79 mm, P=0.113) were also not statistically different between the two groups. There were statistical differences in AAD before, after operation and at follow-up in each group. All 41 patients were followed up for 23-108 (57.07±28.60) months, with a median follow-up of 51.00 months. Compared with that before discharge, the AAD growth rate at the last follow-up was –1.50-6.78 mm/year, with a median growth rate of 0.70 mm/year, and only 3 patients had an annual growth rate of above 3 mm/year. Conclusion    Mid- and long-term outcomes of RAA in adult patients undergoing AVR with both methods are satisfying and encouraging.