Primary repair of ascending aortic dissection: Experience with 20 cases

Abstract

A primary repair technique was used to treat 20 cases of dissection of the ascending aorta. The group consisted of 13 men and 7 women with an average age of 65 years. Dissection complicated cardiac surgery in 13, was spontaneous in 6, and was traumatic in 1. The repair included a noncircumferential aortotomy at the site of the primary tear sparing the posterior wall, followed by Teflon felt-supported repair of the dissected layers, and wrapping of the aorta with a Teflon felt pad. Concomitant procedures included coronary bypass grafts in 12, valve surgery in 3, and closure of infarction-related ventricular septal defect in 1. Two patients died (mortality 10%). Postoperative complications were relatively frequent in the remaining 18 patients. All survivors were stable for an average follow-up period of 2 years. Compared with replacement grafting, this procedure is less time-consuming and probably provides better stability of the ascending aorta.