Journal of cardiac surgery
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From October 1973 to December 1995, 251 patients (204 male, 47 female) aged from 10 to 75 years (mean: 46.6 +/- 15) underwent an ascending aortic replacement with a composite graft for: dystrophic aneurysm (AN), 168 cases (66.9%); chronic dissection (CD), 36 cases (14%); and type A acute dissection (AD), 48 cases (19.1%). Fifty-one patients (20.3%) suffered from Marfan's disease (25 AN, 17 AD, 9 CD). Thirty-seven patients (14.7%) had undergone a previous cardiac or aortic operation. The ascending aortic replacement was extended to the transverse arch in 31 patients (12.3%). A mechanical valve was used in 233 patients (92.8%). The classic "Bentall" technique was used in 87 patients (34.6%), the "button" technique in 121 patients (48.2%), the "Cabrol" technique in 26 patients (10.3%) and a "mixed" technique in 17 patients (6.2%). ⋯ Ascending aortic replacement with a composite graft is a safe procedure, especially when performed electively in patients with dystrophic aneurysm or Marfan's disease. The technique of coronary reimplantation has a significant influence of the long-term results, with the reimplantation of choice being the "button" technique. The "Cabrol" technique must be used when the "button" or the "Bentall" reimplantation is not feasible.
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The mortality and morbidity associated with surgery for aortic root abscess is reportedly high. This is a review of our experience with radical resection of the abscess and reconstruction of the left ventricular outflow tract with pericardium. ⋯ Radical resection of aortic root abscess and reconstruction of the left ventricular outflow tract with pericardium is an effective method to eradicate the infection. These patients appear to have a relatively high risk of recurrent endocarditis.