Surgical Treatment
Surgical Treatment
Graft Replacement
For ascending aneurysms that do not involve the aortic valve, simply removing the diseased portion of the aorta and replacing it with a tube graft is sufficient treatment. The aorta is usually replaced with a synthetic graft made of Dacron - a material which is strong and long-lasting. To perform the operation, the heart is stopped and the patient is placed on cardiopulmonary bypass while the segment of aorta is replaced. The aneurysmal portion of the aorta is excised and the tube graft sewn to the remaining aorta.
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Bentall Operation
For ascending aortic aneurysms associated with an abnormal aortic valve, the operation involves removing both the aorta and the aortic valve.
Referred to as the Bentall Operation, both aortic valve and ascending aorta are replaced with a Dacron graft to which is attached a prosthetic aortic valve.
As part of the operation, the coronary arteries are removed from the aorta and re-attached to the aortic graft.
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Valve-Sparing Aortic Root Replacement Bentall Operation
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In patients whose aneurysm involves the aortic root but whose aortic valve is normal, the valve can be saved using this procedure. The ascending aorta and coronary arteries are removed just above the aortic valve and a graft is attached at this level. The coronary arteries are then re-attached to the aortic graft.
Freestyle Aortic Root Replacement
Another approach for aortic root aneurysms is implantation of a Freestyle aortic root, which is a preserved ascending aorta with the aortic valve that have been harvested from a pig. The patient's own aortic valve and ascending aorta are excised, and the Freestyle graft is sewn into place, similar to a Bentall operation. The patient's own coronary arteries are re-attached to the Freestyle graft.
More about ascending aortic aneurysm: Causes Indications Surgical Treatment Neurologic Protection
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