Emergency Aortic Root Remodeling for Rupture of a Large Ascending Aortic Aneurysm
Etsuro Suenaga
Hisao Suda
Tsuyoshi Itoh*
(Department of Cardiovascular Surgery, Nagasaki Kouseikai Hospital, Nagasaki,
Japan and Department of Thoracic and Cardiovascular Surgery, Saga Medical
School*, Saga, Japan)
Aortic valve preservation is indicated in cases of aortic regurgitation
caused by sinotubular junction (STJ) dilatation with ascending aortic aneurysm.
We performed aortic remodeling using a tailored Dacron graft for the rupture
of a large ascending aortic aneurysm. The patient was a 68-year-old woman.
She was admitted in shock with cardiac tamponade. Chest CT showed a large
ascending aortic aneurysm, 11 cm in maximum diameter. Echocardiography
demonstrated moderate cardiac effusion and massive aortic regurgitation.
The ascending aorta was dilated from the STJ to the innominate artery,
but the aortic valve appeared normal. We decided to preserve the native
aortic valve. We performed aortic root remodeling using a 26 mm Dacron
graft (Yacoub's procedure). An intraoperative endoscopic study revealed
the disappearance of aortic regurgitation (AR). The coronary arteries were
reconstructed by the Carrel patch technique. Postoperative aortography
revealed trivial AR, and the patient was discharged two weeks after the
operation. We conclude that this technique avoids the complications associated
with mechanical valve implantation and necessary lifetime anticoagulation.
Jpn. J. Cardiovasc. Surg. 29: 410-413 (2000)
