Operation for ascending aortic aneurysm and aortic regurgitation--pathological influence on survival.
Jpn J Surg
; 17(6): 425-30, 1987 Nov.
Article
en En
| MEDLINE
| ID: mdl-3325670
ABSTRACT
The author briefly reviews the early operations of treatment of aortic aneurysm and aortic regurgitation leading to his description, in 1968, of the first composite graft replacement of the ascending aorta and aortic valve, with anastomosis of the coronary arteries into the graft. The original operation is described with reference to modifications suggested by a number of authors throughout the last 20 years. Methods of achieving coronary artery continuity by Carrel patch and pull-through by saphenous vein interposition and by synthetic graft techniques are discussed. While any of these methods may be needed in individual cases the preference of the author remains for simplicity. The arguments for and against excision of the aneurysmal sac are considered in relation to the control of haemorrhage. The early and medium term results of operation are good but in comparing results world-wide a lack of uniform diagnostic criteria is apparent. The full clinical Marfan syndrome presents little difficulty but the status of "annuloaortic ectasia", Erdheim's medionecrosis, "cystic medial necrosis" and many other pathological descriptions are not defined "forme fruste" of Marfan's disease has been used for any of the above. Interpretation of surgical results remains difficult and often impossible in the absence of clear definitions. Recent work on elastic tissue and on the chemistry of collagen together with the hope of identification of the genetic background now offers real hope of clearer understanding.
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Banco de datos:
MEDLINE
Asunto principal:
Aneurisma de la Aorta
/
Insuficiencia de la Válvula Aórtica
Tipo de estudio:
Prognostic_studies
Límite:
Humans
Idioma:
En
Año:
1987
Tipo del documento:
Article