Sino-tubular junction stabilization as an viable approach for aortic insufficiency in ascending aortic aneurysms

Abstract

Introduction. Aortic insufficiency caused by ascending aortic aneurysm with concomitant dilation of the sino-tubular junction requires combined surgery. To date there is a lack of relevant papers.Aim: To analyze early and mid-term outcomes in patients undergoing ascending aortic replacement with sino-tubular junction stabilization for aortic insufficiency.Methods. The retrospective study included 57 patients with ascending aortic aneurysm and aortic insufficiency who underwent aortic replacement from December 2011 to January 2024. All patients were stratified into 2 groups according to aortic regurgitation (AR) grade: 1st group included patients with 1 grade, 2d group - patients with 2 grade. We analyzed clinical early and mid-term outcomes.Results. There were no significant differences in neurological, pulmonary, renal complications as well as bleeding and mortality in the early postoperative period. Mid-term survival was 100% and 87.4% in the AR 1 grade and AR 2 grade, respectively. In both groups, the volumetric parameters of the left ventricle and size of the aorta at all levels studied were decreased in the postoperative period. There were no patients with recurrent or increased aortic insufficiency. No patient required proximal aortic reoperation.Conclusion. Ascending aortic replacement with concomitant sino-tubular junction stabilization without additional aortic cusp repair and/or aortic root surgery is a safe and durable procedure providing reduce the aortic insufficiency regurgitation grade.