Background
We aimed to determine the long-term outcomes of reduction ascending aortoplasty and
ascending aortic replacement. A secondary aim was to document our experience with
the long-term “growth” of woven Dacron grafts.
Methods
Over a nine-year period (1992–2001), 154 patients underwent aortic valve replacement
using the Ross procedure for bicuspid aortic valve disease (BAV). Twenty-five also
underwent reduction ascending aortoplasty (RAA), and 16 underwent ascending aorta
replacement (AAR), using a Dacron graft. Preoperative diameters were measured prospectively.
Patients had a follow-up CT chest between January and December 2007 to measure the
mid-ascending aortic diameter.
Results
Mean age at operation was 31.8 ± 13.5 years (RAA), and 40.0 ± 8.6 years (AAR) (p = NS). Mean follow-up was 101 months (±43.0, 95% CI) in the RAA group, and 107 months
(±29.0, 95% CI) in the AAR group. Mean pre-operative diameter in the RAA group was
41.5 mm (±11.8, 95% CI) and in the AAR group 46.2 mm (±7.8, 95% CI) (p = 0.004). Mean follow-up diameter in the RAA group was 35.4 mm (±4.6, 95% CI) and in the AAR group 31.9 mm (±6.8, 95% CI) (p = 0.003). Growth of the woven Dacron prosthesis was 23.4% (±26.8, 95% CI) in the 107-month
follow-up period. There was no early or late mortality and no further aortic surgery
during follow-up.
Conclusions
We have demonstrated satisfactory long-term outcomes with both RAA and AAR in patients
with BAV related aortopathy who have undergone the Ross procedure. We have noted a
greater diameter reduction with AAR when compared with RAA over nine years.
In this series, “growth” of the woven Dacron grafts occurred, however individual measures
did not correlate with other studies.
Keywords
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Article info
Publication history
Accepted:
March 28,
2009
Received in revised form:
March 14,
2009
Received:
November 16,
2008
Footnotes
☆Presented at the Australasian Society of Cardiothoracic Surgeons 2008 Annual Scientific Meeting, Noosa, Australia 15–19 October 2008.
Identification
Copyright
© 2009 Published by Elsevier Inc. All rights reserved.
