The Annals of Thoracic Surgery, Vol 26, 142-148, Copyright © 1978 by The Society of Thoracic Surgeons
Surgical treatment of annuloaortic ectasia with composite grafts including homologous dura mater valves
RK Kalil, PC Azambuja, VE Bertoletti, FA Lucchese, PR Prates and IA Nesralla
We describe 3 patients in whom a composite dura mater valve-Dacron tube
graft was used for replacement of the entire ascending aorta and aortic
valve. Two patients had Marfan's syndrome and 1, a chronic aortic
dissection, type II. All had severe aortic regurgitation. There were no
early or late deaths in a follow-up period of 2, 7, and 12 months,
respectively. All 3 patients were asymptomatic when last seen. Two
underwent postoperative aortography that disclosed well-functioning valves
and good filling of the coronary arteries. It is concluded that
annuloaortic ectasia is best treated by the technique of total replacement
of the ascending aorta and aortic valve by a composite valve-tube graft,
and that the homologous dura mater valve, for its characteristics of
central flow, lack of need for anticoagulants, and durability, represents a
reasonable alternative for use in this situation.