RÉSUMÉ
We present early results and long-term follow-up after reduction aortoplasty with external wrapping of the ascending aorta. From December 1993 to February 2008, 32 consecutive patients who had reduction aortoplasty were compared with 47 consecutive patients who underwent prosthetic graft replacement of the ascending aorta. The groups were similar in baseline characteristics. Patients in the reduction aortoplasty group had significantly shorter aortic crossclamp times (18.78 +/- 1.91 vs. 34.04 +/- 3.25 min) and cardiopulmonary bypass times (30.16 +/- 2.36 vs. 60.83 +/- 2.05 min), and they received fewer transfusions. There was no significant enlargement of the aortic diameter at the level of the sinus of Valsalva in the reduction aortoplasty group during the follow-up period (from 38.84 +/- 3.10 to 39.48 +/- 2.72 mm). Reduction aortoplasty with external wrapping of the ascending aorta is a simple and promising surgical method. Our experience shows that this technique is the procedure of choice in patients without aortic dissection and with an appropriately sized sinus of Valsalva.
Sujet(s)
Anévrysme de l'aorte/chirurgie , Implantation de prothèses vasculaires , Procédures de chirurgie vasculaire , Adulte , Anévrysme de l'aorte/complications , Anévrysme de l'aorte/mortalité , Anévrysme de l'aorte/anatomopathologie , Insuffisance aortique/étiologie , Transfusion sanguine , Implantation de prothèses vasculaires/effets indésirables , Implantation de prothèses vasculaires/mortalité , Pontage cardiopulmonaire , Constriction , Femelle , Humains , Durée du séjour , Mâle , Adulte d'âge moyen , Sélection de patients , Réintervention , Appréciation des risques , Sinus de l'aorte/anatomopathologie , Facteurs temps , Résultat thérapeutique , Procédures de chirurgie vasculaire/effets indésirables , Procédures de chirurgie vasculaire/mortalitéRÉSUMÉ
A modified muscle-sparing high approach to the thoracoabdominal aorta is described, which improves surgical access for thoracoabdominal aortic aneurysm repair. Since 2000, 16 patients with type I and II thoracoabdominal aortic aneurysms have undergone aortic graft replacement using this approach via the 3(rd) intercostal space. There were no hospital deaths. Three (18.8%) patients had severe postoperative pain requiring prolonged analgesia. This approach is a good alternative to the standard approach via the 6(th) intercostal space.
