Replacement of the ascending aorta and aortic valve with a composite graft. Results and follow-up in 71 patients.

Composite graft replacement of the ascending aorta and aortic valve was performed in 71 patients over an 8-year period. Degenerative lesions of the aortic root in Marfan's syndrome (annuloaortic ectasia) was the indication for operation in 51 cases. Other causes of aortic root dilatation and aortic valve disease were present in the remaining 20 patients. Overall hospital mortality was 8%. Reoperation was required in 6 of the 65 hospital survivors. Follow-up has ranged from 1 to 9 years (average 41/2 years). Four year actuarial survival was 77%. Composite graft replacement eliminates paraprosthetic leakage and the risk of aneurysm formation of the sinuses of Valsalva; postoperative hemorrhage is also reduced. It appears to be the method of choice for the aortic root complications of the Marfan's syndrome.