Composite graft repair of the ascending aorta for annuloaortic ectasia. Report of 2 cases

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  • YAMAMOTO SHIN
    Department of Thoracic Surgery, Juntendo University School of Medicine
  • SASAGURI SHIRO
    Department of Thoracic Surgery, Juntendo University School of Medicine
  • HAYASHI ICHIRO
    Department of Thoracic Surgery, Juntendo University School of Medicine
  • FUKUDA TOMONOBU
    Department of Thoracic Surgery, Juntendo University School of Medicine
  • HOSODA YASUYUKI
    Department of Thoracic Surgery, Juntendo University School of Medicine

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  • Annuloaortic ectasiaに対しcomposite graftおよびCarrel patchを用いて大動脈基部再建術を行った2手術例

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Two patients with annuloaortic ectasia underwent composite graft repair of an ascending aorta. (case 1) A 30-year-old man was admitted to the hospital because of type A aortic dissection associated with annuloaortic ectasia. A magnetic resonance image, computed tomography of the aorta demonstrated aortic enlargement with dissection, but revealed no evidence of dissection of the aortic arch. A transesophageal echocardiography demonstrated dissection of the aortic arch. A graft replacement of the total aortic root were performed using hypothermic circulatory arrest with retrograde cerebral perfusion and open distal anastomsis. We reconstructed coronary ostia with Carrel patch, and discontinued the operation without major bleeding. No neurological deficit was found postoperatively. (case 2) A 50-year-old man who had underwent aortic valve replacement for aortic regurgitation was admitted to the hospital because of enlargement of ascending aorta. Preoperative aortogram shows dilated ascending aorta (80mm in diameter). A graft replacement of the total aortic root were performed and we reconstructed coronary ostia with Carrel patch, and completed the operation without major bleeding. There is no complication after the operation.

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