Efficacy Of The Surgical Management In Patients With Aortic Valve Diseases Complicating Ascending Aortic Dilatation

Objective:The optimal management of dilated ascending aorta during aortic valve replacement(AVR) remains controversial.This study compared the outcomes among three different managements(AVR alone, aorta wrapping, and aorta replacement) for the dilated ascending aorta.Preliminarily summarize the surgical indications and the surgical methods.Methods:The study enrolled 112 patients with aortic valve diseases concomitant with ascending aorta dilatation(diameter range from 40 mm to 55 mm) and We excluded patients with Marfan‘s syndrome, aortic dissection, atheroselerosis of aorta at the 1st Affiliated Hospital of Anhui Medical University from January 2009 to June 2015. The clinical materials were retrospectively analyzed. During the follow-up,we recorded the cardiac function(NYHA)、 left ventricular ejection fractions(LVEF)、The aortic diameter、the aortic expansion rate by echocardiography and recorded adverse aortic events.Results:Complete data were obtained of 104 patients which were followed up for an average of 28.0±16.9 months( range 2,54 months),totally followed up 28.0 p-ys. Seventy-four were males and thirty were females with a mean age of 54.9±9.8 years. A total of 56 patients had AVR,17 patients ascending aortoplasty(13 patients reduction angioplasty and 4 patients aorta wrapping),and 31 patients aorta replacement. There were no aortic complication and aortic dissection occurrence during the follow-up interval of 2 to 54 months. There was no significant difference between the three groups(aortic valve stenosis VS aortic insufficiency VS aortic valve stenosis combining insufficiency) in aortic expansion rates(P=0.18),moreover,there was no significant difference between the aortic expansion rates and the initial aorta diameter(γ=0.16,P>0.05)。Conclusions:Aortic valve replacement alone may be reasonable in patients with aortic valve diseases concomitant with ascending aorta dilatation( diameter range from 40 mm to 55 mm); The aortic expansion rates were affected neither by the morphology of aortic valves nor by the initial aorta diameter.