Reduction aortoplasty for dilatation of the ascending aorta in patients with bicuspid aortic valve Matthias Bauer, MD, Miralem Pasic, MD, PhD, Raymond.

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Presentation transcript:

Reduction aortoplasty for dilatation of the ascending aorta in patients with bicuspid aortic valve Matthias Bauer, MD, Miralem Pasic, MD, PhD, Raymond Schaffarzyk, MD, Henryk Siniawski, MD, Friedrich Knollmann, MD, Rudolf Meyer, MD, PhD, Roland Hetzer, MD, PhD The Annals of Thoracic Surgery Volume 73, Issue 3, Pages 720-723 (March 2002) DOI: 10.1016/S0003-4975(01)03455-5

Fig 1 Technique of reduction aortoplasty begins with longitudinal incision of ascending aorta (A) and resection of oval segment of ascending aortic wall (B). The Annals of Thoracic Surgery 2002 73, 720-723DOI: (10.1016/S0003-4975(01)03455-5)

Fig 2 After resection, longitudinal aortotomy is closed in two rows using polypropylene 4-0 suture (A). First row is continuous mattress suture (B), followed by over-and-over continuous suture (C). The Annals of Thoracic Surgery 2002 73, 720-723DOI: (10.1016/S0003-4975(01)03455-5)

Fig 3 Preparation of Dacron tube graft for wrapping of ascending aorta. Prosthesis is cut longitudinally (A and B) and two pieces of the prosthesis are excised from the ends of the graft (C), forming a “butterfly” shape of the prosthesis (D). The Annals of Thoracic Surgery 2002 73, 720-723DOI: (10.1016/S0003-4975(01)03455-5)

Fig 4 Wrapping of ascending aorta with prosthetic graft. Graft is pulled below aorta (A), oversewn with continuous suture, and fixed to aortic wall at ends (B). The Annals of Thoracic Surgery 2002 73, 720-723DOI: (10.1016/S0003-4975(01)03455-5)

Fig 5 Survival of patients after reduction aortoplasty (Kaplan-Meier curve ± 95% confidence interval). Number of patients at risk at each time point is given. The Annals of Thoracic Surgery 2002 73, 720-723DOI: (10.1016/S0003-4975(01)03455-5)

Fig 6 Mean diameter (± standard deviation) of ascending aorta of all patients during follow-up period. Number of patients at risk at each time point is given. (OP = operation; preop = preoperatively.) The Annals of Thoracic Surgery 2002 73, 720-723DOI: (10.1016/S0003-4975(01)03455-5)

Fig 7 Mean diameter of ascending aorta of group I (with no external support) and group II (with external support) during follow-up. There was no difference in mean diameter of ascending aorta between groups I and II during postoperative period. Numbers of patients at risk at each time point are given. (OP = operation; preop = preoperatively.) The Annals of Thoracic Surgery 2002 73, 720-723DOI: (10.1016/S0003-4975(01)03455-5)

Fig 8 Mean diameter of ascending aorta in patients with and without redilatation of ascending aorta (by > 4 mm) during follow-up. Numbers of patients at risk at each time point are given. (OP = operation; preop = preoperatively.) The Annals of Thoracic Surgery 2002 73, 720-723DOI: (10.1016/S0003-4975(01)03455-5)