Surgical management of patients with ascending aortic aneurysms.

Between 1988 and 2002, 104 patients with ascending aortic aneurysms were operated on. The patients were distributed into 2 groups: the first group presented with aortic incompetence (n=66) and the second one had no aortic incompetence (n=38). In the first group, 8 patients received valvesparing operations, 58 (88%) patients underwent replacement of the aortic valve and ascending aortic segment according to different techniques. In the second group, 20 (53%) patients underwent graded aneurysmal resection and intimasparing exoreplacement by synthetic grafts and 18 (47%) were provided supravalvular replacement of the ascending aorta. In the shortterm postoperative period, the lethality in the first group accounted for 3% (6 patients), in the second group, it was equal to 2.6% (1 patient): of note, in the group provided aortoplasty, the lethality was 0%. In ascending aortic aneurysm associated with aortic incompetence, the Bentall DeBono operation is the method of choice of surgical treatment. Valvesparing operations are to be performed according to strict indications (in the absence of anuloaortic ectasia and microscopic lesions of aortic valve cusps). The graded resection of aneurysm with intimasparing exoreplacement may be an alternative to linear replacement of the ascending aorta in ascending aortic aneurysm without aortic incompetence and in the absence of aortic wall dissection.