Patients Management with Dilated Aortic Root less than 50 mm with Aortic Insufficiency

Sergey Y. Boldyrev ¹, Olga A. Rossoha ¹, Eugeny A. Terman ¹, Angelina A. Polyakhova ², Olga N. Ponkina ¹, Kirill O. Barbuhatty ¹, Vladimir A. Porhanov ¹

¹ Department for Adult Cardiac Surgery, S.V. Ochapowski Regional Hospital 1, Krasnodar, Russia, Krasnodar, Russia; ² Kuban State medical University , Krasnodar, Russia;

Date, time and location: 2018.05.25 13:30, Exhibition area, 1st Floor. Zone – C

Abstract

Introduction.

The question of management of patients with dilated ascending aorta of 40-50 mm has not been studied enough. It has increased the risk of a possible rupture/dissection of the ascending aorta. Modern Guideline has not enough information about this problem.

Objective.

To conductthe comparative study of indexed echocardiographic parameters of escending aortaand histological comparison of the aortic wall samples taken intraoperatively in patients with different introductory characteristics.

Materials and methods. The study involved 60 patients who were divided into three groups: «Norma», «Dilatation», «Aneurism».

Comparisons between the groups were performed according to the following parameters: age, Sm2 of the body, indexed linear dimensions of the aortic root, histological changes in the structure of the aortic wall.

Results.

The main clinical characteristics of the three groups were similary. (p> 0.1). Based on the statistical comparisons of the indexed linear dimensions of the aortic root, significant differences were revealed betweengroups «Norma» and «Dilation». In the analysis of histological features, the "Dilatation" group has specific characteristics that were similar to «Aneuvrism» group due to increasing of histopathological grading of "Medionecrosis", "Cystic medioneecrosis", "Changes in the orientation of smooth muscle fibers", "Fragmentation of elastic fibers" (p <0.001 ). In group of «Dilatation» all patients were undergone of aortic valve reimplatation procedure.

Conclusion.

Taking into account the results of the conducted search, the "Dilation" group is statistically characterized by more pronounced degenerative changes in the aortic wall as opposed to the "Norma" group. We belive that patients with dilation ascending aorta less 50 mm requires a more agrrasive managment for preventing of aortic rupture/dissection.