Minimally invasive replacement of ascending aortic aneurysms: intermediate term results

• Published in: The Heart surgery forum Vol. 2; no. 2; p. 139
• Main Authors: Karagoz, H Y, Kurtoglu, M, Battaloglu, B, Sonmez, B, Bakaloglu, B, Ozerdem, G, Bayazit, K
• Format: Journal Article
• Language: English
• Published: United States 1999
• Subjects: Aged; Aortic Aneurysm - classification; Aortic Aneurysm - etiology; Aortic Aneurysm - mortality; Aortic Aneurysm - surgery; Blood Vessel Prosthesis Implantation - adverse effects; Blood Vessel Prosthesis Implantation - instrumentation; Blood Vessel Prosthesis Implantation - methods; Female; Follow-Up Studies; Hemorrhage - etiology; Hemorrhage - surgery; Humans; Length of Stay - statistics & numerical data; Male; Marfan Syndrome - complications; Middle Aged; Minimally Invasive Surgical Procedures - adverse effects; Minimally Invasive Surgical Procedures - instrumentation; Minimally Invasive Surgical Procedures - methods; Reoperation; Stroke - etiology; Survival Analysis; Time Factors; Treatment Outcome
• ISSN: 1098-3511

Minimally invasive techniques have gained recent interest in the realm of cardiac surgery. This report describes our initial experience with graft replacement of ascending aortic aneurysms using a superior mini-sternotomy approach.
Between March 1997 and October 1997, four patients underwent operation for ascending aortic aneurysm via superior mini-sternotomy approach. There were two female and two male patients, ranging in age from 52 to 62 years (mean 53.7 +/- 7.6). All patients had the stigmata of Marfan's syndrome. Mean diameter of the ascending aortas was 6.1 +/- 0.9 cm. Composite graft replacement with coronary reimplantation was performed in all cases. In one patient hemiarch replacement was performed under total circulatory arrest. There was no hospital (30-day) mortality. Mean aortic cross clamp and cardiopulmonary bypass times were 63 +/- 14.1 minutes (range 44 to 78) and 116.7 +/- 43.3 minutes (range 81 to 177), respectively. One patient was re-explored for bleeding.
Lengths of hospital stay ranged from 5 to 7 days (mean 5.5 +/- 1). Patients were followed-up for at least 18 months. One patient suffered a fatal stroke in her third postoperative month. All surviving patients were in NYHA Class I at the sixth postoperative month and thereafter.
Minimally invasive graft replacement of ascending aortic aneurysms can be performed safely and effectively. Long term results are likely to be similar to those of conventional cases performed through a full median sternotomy.