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Ascending Aortic Aneurysm Resection: 15 Years’ Experience

Escorts Heart Institute and Research Center, New Delhi, India

For reprint information contact: Zile S Meharwal, MCh Tel: 91 11 2682 5000 Fax: 91 11 2682 5013 Email: meharwal{at}hotmail.com, Escorts Heart Institute and Research Center, Okhla Road, New Delhi 110025, India.

Between September 1989 and June 2004, 148 consecutive patients underwent ascending aortic replacement for aneurysm or dissection. There were 130 males (88%) and 18 females (12%). Their mean age was 46.20 ± 13.36 years. Fifty-seven patients (39%) were treated for type 1 and type 2 aortic dissection, and 91 (61%) for ascending aortic aneurysm. The Bentall procedure was performed in 81 patients (55%), the Cabrol procedure in 7 (5%), separate ascending aortic replacement and aortic valve replacement or repair was carried out in 24 (16%), and ascending aortic replacement only in 36 (24%). Hospital mortality was 4.05% (6 deaths). On univariate analysis, left ventricular ejection fraction 30%, emergency surgery, contained rupture, concomitant coronary artery bypass grafting, and age 65 years were risk factors for early mortality. However, on multivariate analysis, ejection fraction 30% and contained rupture were the only factors significantly associated with early mortality. The long-term survival rates were 87.2% ± 3.7% at 5 years, 78.0% ± 5.6% at 10 years, and 60.9% ± 9.9% at 15 years. Ascending aortic resection for aneurysm or dissection can be performed with low mortality and morbidity.

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