Long-term durability of resection and end-to-end anastomosis for ascending aortic aneurysms Massimo Massetti, MD, Sebastien Veron, MD, Eugenio Neri,

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Presentation transcript:

Long-term durability of resection and end-to-end anastomosis for ascending aortic aneurysms Massimo Massetti, MD, Sebastien Veron, MD, Eugenio Neri, MD, Olivier Coffin, MD, Olivier le Page, MD, Gerard Babatasi, MD, PhD, Dimitrios Buklas, MD, Dominique Maiza, MD, Jean Louis Gerard, MD, Andre Khayat, MD The Journal of Thoracic and Cardiovascular Surgery Volume 127, Issue 5, Pages 1381-1387 (May 2004) DOI: 10.1016/j.jtcvs.2003.11.065

Figure 1 Ascending aorta is crossclamped distal to aneurysm and opened. Aneurysm is resected between two circumferential aortotomies: first at level of sinotubular junction and second at distal edge of aneurysm (A). Horizontal aorta is then largely mobilized, mainly by dissecting first portion of supra-aortic trunks (B) and by dissecting pericardial reflections adjacent to inferior vena cava and left atrium (C). This part of operation can be performed before aortic crossclamping. Two ends of aorta, without tension, are finally sutured with a continuous 4-0 polypropylene suture (D). The Journal of Thoracic and Cardiovascular Surgery 2004 127, 1381-1387DOI: (10.1016/j.jtcvs.2003.11.065)

Figure 2 Cumulative survival (Kaplan-Meier method) for 34 patients in entire series who underwent aortic resection and end-to-end anastomosis. Major vertical lines indicate 95% confidence intervals of proportion. The Journal of Thoracic and Cardiovascular Surgery 2004 127, 1381-1387DOI: (10.1016/j.jtcvs.2003.11.065)

Figure 3 Mean aortic diameter, using all available measurements of 34 patients, before CPB (A), after CPB (B, 34 patients), at discharge (C, 33 patients), and at follow-up (end of follow-up, 29 patients). For measurements at follow-up, moving band method was used. Mean aortic diameter is given with 70% confidence interval (error bars). The Journal of Thoracic and Cardiovascular Surgery 2004 127, 1381-1387DOI: (10.1016/j.jtcvs.2003.11.065)

Figure 4 Individual increases in aortic diameter of patients with 2 or more measurements available before CPB (A), after CPB (B), and at follow-up. The Journal of Thoracic and Cardiovascular Surgery 2004 127, 1381-1387DOI: (10.1016/j.jtcvs.2003.11.065)