Surgery for Ascending Aorta Aneurysm & Aortic regurgitation
- drpavankumar
- 0
- on Feb 23, 2019
Surgery for Ascending Aorta Aneurysm & Aortic regurgitation
Mrs. Y. T. 33 year old short stratured female had been suffering from Aortic valve leakage / regurgitation since last 10 years. Due to which her ascending Aorta started dilating & gradually became aneurysmal. Last month she was referred for Ascending Aorta aneurysm & aortic valve regurgitation surgery. On admission investigations like Echo showed grade IV / IV aortic regurgitation ,CT scan of aorta showed uniform dilatation of ascending Aorta 5.5cm(proximal AA) – 6.5 (Mid AA) – 4.5cm( distal AA) size.
Coronary angiogram showed normal coronaries. She was taken up for surgery by DR. Pavan Kumar on 31/1/19 . She underwent “Aortic Valve Replacement” by mechanical Aortic valve prosthesis # 21 & dilated ascending Aorta was repaired by Aortoplasty doing reduction of dilated portion by 2.5cm longitudinally strengthened by Teflon felt and overrunning sutures. Patient stood operation well & discharged on 7th Post operative day.
Discussion –
Normally Ascending Aorta Aneurysmal dilatatation are treated by Ascending Aorta root replacement / Bentall’s procedure or Aortic valve sparing operation. These operations are usually carried out on Marfan – syndrome cases when there is connecting tissue disorder in tall stratured patients causing aneurysmal dilatation of ascending Aorta. This thinned out Aorta has high risk of dissection of Aorta or rupture. This patient had normally thickness preserved Aortic wall with even dilatation of ascending Aorta, suitable for repair Aortoplasty. Here a longitudinal long strip of dilated Aorta was taken out & Aorta plicated back with strengthening Teflon felt pieces thus effectively reducing circumference of ascending aorta to less than 5 cm2. It worked well & this dilatation will stabilise in due course time as main cause of dilatation ( Aortic regurgitation) has been removed by replacing the leaking Aortic Valve.