Abstract:

Objective To summarize the clinical experience in surgical management of aortic root in type A aortic dissection. Methods The clinical data of 113 patients with type A aortic dissection were collected, among whom aortic root was involved in 97, and aortic root was uninvolved in 16. Bentall procedure (n=46), reconstruction of Valsalva's sinus (n=48) and Divid procedure (n=3) were employed in the management of involved aortic root. The surgical outcomes and follow-up findings were retrospectively analysed. Results Fourteen patients died early after operation, and the other 99 patients were discharged. Eighty-six patients were followed up for 6 to 108 months. During the follow-up, one of the 26 patients undergoing Bentall procedure died, one of the 45 patients with reconstruction of Valsalva's sinus had gradually enlarged Valsalva's sinus and mild to moderate aortic insufficiency, and one of the 3 patients receiving Divid procedure experienced mild to moderate aortic insufficiency. Conclusion Surgical management of aortic root in type A aortic dissection should be performed according to the condition of aortic root. Reconstruction of Valsalva's sinus is a valvesparing technique with favorable early and intermediate outcomes.

Key words: type A aortic dissection, surgical treatment of aortic root, reconstruction of Valsalva´s sinus