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Charles D. Campbell, MD; Robert L. Hardesty, MD; Ralph D. Siewers, MD; David B. Lerberg, MD; Robert L. Peel, MD; Henry T. Bahnson, MD

Arch Surg. 1978;113(11):1324-1330.

Abstract
• Since 1971, ten patients, 26 to 62 years of age, have undergone repair of ascending aortic aneurysms with concomitant aortic insufficiency. Three patients had Marfan's syndrome, five patients had cystic medial necrosis, one had luetic aortitis, and one had atherosclerotic involvement of the aorta. There was one operative death. Follow-up exceeds seven years.

Because of the tendency for progressive annular and sinus dilation in Marfan's syndrome, composite graft and valve conduits with reimplantation of the coronary arteries is the procedure of choice. In selected patients with annuloaortic ectasia, good valve tissue and no sinus dilation, bicuspidization of the valve, and replacement of the ascending aorta is indicated. The operation is generally less formidable than composite graft replacement, maintains normal coronary anatomy, and alleviates the long-term risks of anticoagulation.

(Arch Surg 113:1324-1330, 1978)

Author Affiliations
From the Departments of Surgery (Drs Campbell, Hardesty, Siewers, Lerberg, and Bahnson) and Pathology (Dr Peel), University Health Center Hospital, Pittsburgh. Dr Campbell is now with the University of Chicago.

Footnotes
Accepted for publication July 31, 1978.

Presented at the 26th scientific meeting of the International Cardiovascular Society, Los Angeles, June 24, 1978.

Reprint requests to Division of Cardiac Surgery, Michael Reese Hospital and Medical Center, Chicago, IL 60616 (Dr Campbell).