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Tratamento cirúrgico para ectasia anulo-aórtica

DOI: 10.1590/S0102-76381986000100007

Keywords: annulo-aortic ectasia [surgery].

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Abstract:

this is a report of 27 patients presenting annulo-aortic ectasia submitted to surgical correction with a composite valve-tube graft (bentall-de bono technique), between 1976 and 1985. twenty three (85.2%) had cystic medial necrosis, 3 (11,1%) were chronic aortic disections and 1 (3.7%) was luetic aortitis. age ranged from 29 to 64 years (m = 48). three were female and 24 male patients. the valves used were homologous dura maier in 7 cases, heterologous aorta in 9 and mechanical prosthesis in 11. functional class (nyha) was i-ii in 7 and iii-iv in 9 patients. there was 1 (3.7%) hospital death, due to bleeding and renal failure. significant early complications were represented by arrhythmias in 13 cases (48%) and bleeding in 3 (11%). in the late follow-up therev.were 9 deaths, due to: sudden death (2 patients, 7.4%), bleeding in reoperation (1 patient, 3.7%), hospital infection (1 patient, 3.7%), infectious endocarditis (1 patient, 3.7%) and accidental causes (2 patients, 7.4%). five patients (18.5%) needed reoperation in the late follow-up: 2 due to bioprosthetic failure, 2 for replacement of an infected dacron tube and 1 for repair of pseudo-aneurysm and periprosthetic leak. the actuarial survival curve showed a probability of 83.7% up to the 3rd. year, 61 % for the 5th. year and 42.7% from the 6th. to the 9th. year of follow-up. the 17 patients surviving are in functional class i-ii (nyha). the composite valve-dacron tube graft (bentall-de bono) technique for correction of annulo-aortic ectasia is associated with a low hospital mortality. the improvement in functional class is significant. there have been a small number of complications and the long term survival is very satisfactory.

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