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  • Title: Surgical experience with "waistcoat aortoplasty": an update.
    Author: Della Corte A, De Santo LS, Amarelli C, Romano G, De Feo M, Torella M, Scardone M, Cotrufo M.
    Journal: Ital Heart J; 2003 Dec; 4(12):875-9. PubMed ID: 14976853.
    Abstract:
    BACKGROUND: Some patients with primary aortic valve disease can present with an associated asymmetrical dilation of the aortic root and/or ascending aorta without diffuse congenital aortic wall defects. In such cases "waistcoat aortoplasty" has been performed: the present study updates the report of the results of 73 procedures. METHODS: Seventy-three patients underwent aortic valve replacement and waistcoat aortoplasty. Sinus dilation was repaired by plicating the subcoronary redundant aortic wall using the anchoring sutures of the valve prosthesis. Through a triangular resection the most diseased segment of the aortic wall was removed and the aorta was reconstructed with a double layer technique. Thus autologous reinforcement of the convex right postero-lateral wall and stress reduction on the aortotomy suture line were both achieved. Echocardiography was performed preoperatively, postoperatively and then every 6 months. The paired Student's t-test was employed to evaluate the significance of the diameter variations. RESULTS: The procedure was performed with no hospital mortality and a low postoperative morbidity. The post-reduction diameters at the sinuses, sinotubular junction and ascending aorta were significantly smaller than the preoperative ones (p < 0.001). During an echocardiographic follow-up of 39.2 +/- 12.5 months (range 14-58 months), no significant increase in the root (p = 0.18), sinotubular junction (p = 0.22), and ascending diameter (p = 0.34) was observed. CONCLUSIONS: Although further studies are needed to confirm these results in the longer term, waistcoat aortoplasty should be taken into consideration in case of asymmetric ascending dilation secondary to aortic valve disease-related medial degeneration.
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