Fate of the moderately diseased aorta; a single center experience.
Abstract
Background The fate of the aorta after tube graft replacement remains
unclear as is the future of aortic dilatation in patients receiving
other cardiac operations. We investigated the evolution of aortic
dilatation after non aortic cardiac operations and the dimensions of the
root and arch after ascending aorta replacement. Methods From 252
patients with aortic dilatation operated from January 2010 to June 2019,
160 were followed with computed tomography angiography. Two groups were
formed according to the initial operation received. Group I (n=36)
included patients with a dilated aorta, unreplaced during different
indication cardiac surgery. Group II (n=124) included patients receiving
tube graft aorta replacement with or without aortic valve replacement.
Mean preoperative and follow-up diameters of the different aortic
segments were compared in both groups using the two sided paired t-test
for repeated measurements. Results 18 patients died during follow-up,
with one death occurring during reoperation for a false aneurysm of the
distal anastomosis on the aortic arch. There was no other re-operation
for aortic aneurysm, rupture or dissection. In group I the aortic arch
diameter increased slightly, while the rest of the aortic segments
remained stable. In group II the aortic root diameter decreased slightly
while the aortic arch remained stable. Conclusion Ascending aorta
replacement with a tube graft remodeled the aortic root and did not
allow progressive dilatation of the aortic arch. In patients with
moderate ascending aorta dilatation, the unreplaced ascending aorta and
aortic root remained relatively stable but the aortic arch increased
slightly during followup.