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Second Congress of Cardiology and Angiology of Bosnia & Herzegovina

 

SURGERY OF THE ASCENDING AORTA AT THE CARDIAC SURGERY CLINIC OF THE CLINICAL CENTRE OF THE UNIVERSITY IN SARAJEVO
H. Vila, V. Velebit, J. Maurice, I. Pezo, S. Pandur, I. Haxhibeqiri-Karabdić, F. Kučukalić, S. Straus, E. Đonlić, E. Mujičić and M. Kulić
Cardiac Surgery Clinic, Clinical Center University of Sarajevo, Bosnia and Herzegovina

Surgical treatment of diseases of the ascending aorta remains a challenge for cardiac surgeons. The diverse manifestations of the aortic disease, with possible involvement of the aortic valve and coronary ostia, require an excellent knowledge of anatomy of aortic root and possible surgical solutions. Furthermore, the complex anatomy and sometimes, bad quality of tissues may lead to bleeding and other complications if excellent surgical technique is not used. Patients and methods: Between October 1998 and March 2001, we have operated 8 patients with aneurysms of the ascending aorta, 6 men and 2 women, mean age of 50 years. All patients were operated through a median sternotomy. We have performed femoral cannulation in 2 patients and aortic cannulation in 6 patients. Normothermia and cold blood cardioplegia were used in all cases. No patients required circulatory arrest. In 2 our patients we did aortic valve replacement with supracoronary resection of the ascending aorta. 3 patients underwent a valve sparing aortic root replacement (Tirone David procedure) using an impregnated Dacron prosthesis. Results: There was no mortality in this small group. Average cross-clamping time was 92 minutes, no patients required reintervention for postoperative bleeding or other reasons. No patient had a per-operative myocardial infarction or neurologic complications. One patient with a valve sparing aortic root replacement and excellent immediate post-operative result on TEE, developed progressive aortic regurgitation and required reoperation for AVR, 12 months later. Conclusion: Our initial experience with this difficult subset of patients has been satisfactory. We have modified our technique for valve sparing aortic root operations to avoid reccurrent aortic regurgitation .

Drugi kongres kardiologa i angiologa Bosne i Hercegovine
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