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Ann Thorac Surg 1978;26:461-467
© 1978 The Society of Thoracic Surgeons

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Articles

Late Results of Operation for Acute Aortic Dissection Producing Aortic Insufficiency

Department of Surgery, Harvard Medical School and Peter Bent Brigham Hospital, Boston, MA.

^* Address reprint requests to Dr. Collins, Department of Surgery, Peter Bent Brigham Hospital, Boston MA 02115.

Since July, 1970, 8 patients with acute dissecting aneurysms of the ascending aorta producing aortic insufficiency have undergone immediate operation employing a technique in which the origin of the dissection is resected, the dissected base of the aorta is lined with nondistensible prosthetic cloth for support, and the native aortic valve is resuspended. Aortic continuity is then reestablished with end-to-end anastomosis or use of a short segment of woven graft (not necessarily circumferential).

There were no operative deaths. Mean follow-up has been 60 months (range, 25 to 82 months). One late death has occurred (cerebral hemorrage at 48 months); of the remaining 7 patients, 2 have faint murmurs of aortic insufficiency, but all are in New York Heart Association Functional Class I.

This technique of aortic reconstruction in acute ascending dissections allows preservation of the native aortic valve while preventing late aortic root dilatation or major valve insufficiency.

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