Wrapping of the moderately dilated ascending aorta by fresh autologous pericardium

S. Prapas, K. Katsavrias, M. Di Mauro, P. Zografos, S. Guarracini, S. Papandreopoulou, A.M. Calafiore*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background and Aim of the study Wrapping of the ascending aorta (AA), isolated or associated with aortoplasty, has never been completely accepted. Some complications, as folding of the aortic wall, compression of the vasa vasorum and changes in the flow pattern, with consequent dilatation of the proximal arch, have been described. We used fresh autologous pericardium (FAP), so far never reported, to wrap the AA, with the aim to stabilize its size when moderately dilated, maintaining the preoperative dimension or limiting the reduction to a few millimeters. Materials and Methods From 2015 to 2019, 10 patients, who were operated on for valve or coronary surgery or both, underwent wrapping of the AA with FAP. Mean age was 69 +/- 7 years and EuroSCORE II 3.5 +/- 1.7. Four patients had moderately impaired ejection fraction (35%-49%). Results There was no early or late mortality. One patient was reoperated on after 48 months for severe mitral regurgitation. At a follow-up of 53 +/- 14 months, a transthoracic echocardiogram showed that the AA size reduced slightly but significantly, from 45.2 +/- 2.0 to 42.5 +/- 4.1 mm, p = .03. The diameter of the proximal arch remained unchanged, from 37.1 +/- 1.6 to 36.3 +/- 2.9 mm, p = .20. Conclusions In the presence of moderately dilated AA, wrapping can be a reasonable option. The use of FAP stabilizes the size of the aorta after a follow-up of 53 months. Maintaining a size similar to the preoperative one avoids the complications related to the procedure.
Original languageEnglish
Pages (from-to)921-926
Number of pages6
JournalJournal of Cardiac Surgery
Volume37
Issue number4
Early online date28 Jan 2022
DOIs
Publication statusPublished - Apr 2022

Keywords

  • ascending aorta aneurysms
  • fresh autologous pericardium
  • wrapping of the ascending aorta
  • REDUCTION AORTOPLASTY
  • ROOT SUPPORT
  • DILATATION
  • ANEURYSMS

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