C-12 – Redo operations for aneurysm of ascending aorta after previous aortic valve replacement: a purpose of 17 cases

Hakim Himeur, Mourad Aouiche, Rym Bourezak, Abderazak Moussaoui, Rachid Ait Mohand, Chafik Bendamerdji, Salah Eddine Bourezak

Institution : Service de chirurgie cardiovasculaire, EHS Mohamed-Abderrahmani, Bir Mourad Rais, Alger, Algérie

Objectives : Five to fifteen percent of patient undergoing aortic valve replacement (AVR) will have an ascending aortic aneurysm requiring a concomitant surgical procedure. The aim of this study was to evaluate the early and late results for complex surgical procedure of the proximal aorta after previous aortic valve replacement (AVR).

Methods : Between May 2004 to August 2016; 17 patients underwent ascending aortic replacement secondary to aortic valve surgery and mostly for aortic valve replacement (AVR). (12) Males and five (05) Females, mean age 42 years. Mono leaflet prosthesis (03), Starr (03), Double leaflet (06), Bioprosthesis (01), congenital aortic valve stenosis, wrapping of annulo-aortic ectasia (01). The mean time between the first procedure and redo surgery is 20 years.

Results : The 30 days mortality rate is (2/17); emergency repair is associated with higher early mortality. The global survival with the Kaplan-meier method is 93% at 05 years.

Conclusion : Redo surgery for aneurysm of ascending aorta is a major surgical challenge with high postoperative mortality. Patients are at risk for later dissection or rupture of the aortic wall. Elective re-operation for ascending aorta can be accomplished with acceptable mortality.