Late To Mid-term Results Of Aorta Wrapping For Dilated Ascending Aorta

Objectives:The study compares the late to mid-term results of aortic valve replacement and aortic valve replacement combined with aorta wrapping for aortic valve disease with a dilated ascending aorta to discuss the clinical value of aorta wrapping.Methods:The study enrolled 149 consecutive patients in the presence of aortic valve disease with dilated ascending aorta undergoing aortic valve replacement or aorta wrapping in our hospital from January 1st,2010 to December 31,2015. We collected and compared the cardiopulmonary bypass time, aortic blocking time, surgery time, bleeding volume during surgery, ICU days, in-hospital days after surgery, drainage volume, drain time, blood transfusion volume, mechanical respiration time, late complications, follow-up echocardiography between aortic valve replacement group and aortic valve replacement combined with aorta wrapping group to evaluate the late to mid-term results of aorta wrapping.Results:Baseline characteristics such as age, gender, comorbidities, heart function, aortic valve diseases, left ventricle systolic function and size of aortic valve replacement group and aortic valve replacement combined with aorta wrapping group are similar except the ascending aorta diameter which is larger in the latter group (p<0.001). Cardiopulmonary bypass time, aortic blocking time, surgery time, bleeding volume during surgery, pathology of aortic valve, ICU days, in-hospital days after surgery, drainage volume, drain time, blood transfusion volume, mechanical respiration time are of no significant difference between both group. One sternum infection, one cerebrovascular accident occurred in aortic valve replacement group. One death of multi-organ failure, two re-explorations occurred in aorta wrapping group. No other complications such as malignant arrhythmia, cardiac tamponade, acute myocardial infarction occurred in both group. During follow up, one paravalvular leakage and two death occurred in aortic valve replacement group. No death or complications occurred in aorta wrapping group. The average ascending aorta diameter was 44.7±4.5 mm before surgery,43.2±4.8 mm after surgery and 44.3±5.5 mm at last follow up in aortic valve replacement group (P>0.05). The average ascending aorta diameter was 48.3±5.6 mm before surgery,38.5±5.1 mm after surgery and 39.0±5.1 mm at last follow up in aortic valve replacement group. there is significant difference between the average ascending aorta diameter before sugery and after surgery (P<0.001), and no significant difference after surgery and at last follow up (P>0.05).Conclusions:Aorta wrapping technique is a safe and reliable surgery for dilated ascending aorta. The late to mid-term results of it is promising. The long-term results need to be studied.