Surgical procedure and outcomes in patients undergoing surgical treatment for ascending aortic aneurysms

Abstract

Introduction: Ascending aortic aneurysms are lesions that should be surgically handled because of their life-threatening complications like rupture and dissection. Objectives: To examine the early and midterm outcomes of surgical treatment in patients with ascending aortic aneurysm. Method: We retrospectively examined the records of 78 patients who underwent surgical treatment due to ascending aortic aneurysm between August 2006 and July 2018 at Erzurum Regional Training and Research Hospital. Results: The patients' average age was 51,7 ± 9,8 (ranged 24-77 years). There were 54 (69,2%) men and 24 (30,8%) women. Fifty-eight (74,3%) patients had Marfan’s Syndrome. They also presented coronary artery disease (15,4%), mitral stenosis (3,8%), aortic regurgitation (11,5%), aortic stenosis (8,9%), and aortic coarctation (2,6%). The emergency surgical treatment was required in 41 (52,5%) patients. Only 55 (70,5%) patients had performed ascending aortic replacement. Bentall procedure (17,9%) and aortic valve replacement + ascending aortic graft replacement (11,5%) were performed. In 14 patients totally circulatory arrest was used. The operative mortality occurred in 3 (3,8%) patients with Bentall procedure and the early postoperative mortality occurred in 1 (1,3%) patient with aortic coarctation. Conclusions: Patients with ascending aortic aneurysms should be closely monitored for the timing of surgery due to the risk of dissection and rupture. Although various surgical techniques can be applied according to the aortic valve status, especially in patients with Marfan’s Syndrome, root replacement with composite graft, and Bentall modifications and button anastomosis of coronary arteries in composite graft applications should be the preferred surgical procedure.