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WRAPPING OF THE MODERATELY DILATED ASCENDING AORTA BY FRESH AUTOLOGOUS PERICARDIUM
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  • Antonio Calafiore,
  • Sotirios Prapas,
  • Kostas katsavrias,
  • Michele Di Mauro,
  • Panayiotis Zografos,
  • Stefano Guarracini,
  • Stella Papandreopoulou
Antonio Calafiore
Errikos Ntynan Hospital Center
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Sotirios Prapas
Errikos Ntynan Hospital Center
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Kostas katsavrias
Errikos Ntynan Hospital Center
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Michele Di Mauro
Maastricht Universitair Medisch Centrum+
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Panayiotis Zografos
Errikos Ntynan Hospital Center
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Stefano Guarracini
Azienda Sanitaria Locale 3 Pescara
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Stella Papandreopoulou
Errikos Ntynan Hospital Center
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Abstract

Background and aim of the study. Wrapping of the ascending aorta (AA), isolated or associated with aortoplasty, has never been completely accepted. Some complications, as folding of the aortic wall, compression of the vasa vasorum and changes in the flow pattern, with consequent dilatation of the proximal arch, have been described. We used fresh autologous pericardium (FAP), so far never reported, to wrap the AA, with the aim to stabilize its size when moderately dilated, maintaining the preoperative dimension or limiting the reduction to a few mm. Material and Methods. From 2015 to 2019, 10 patients, who were operated on for valve or coronary surgery or both, underwent wrapping of the AA with FAP. Mean age was 69±7 years and ESII 3.5±1.7. Four patients had moderately impaired ejection fraction (35-49%). Results. There was no early or late mortality. One patient was reoperated on after 48 months for severe mitral regurgitation. At a follow up of 53±14 months, a transthoracic echocardiogram showed that the AA size reduced slightly but significantly, from 45.2±2.0 to 42.5±4.1 mm, p=0.03. The diameter of the proximal arch remained unchanged, from 37.1±1.6 to 36.3±2.9 mm, p=0.20. Conclusions. In presence of moderately dilated AA wrapping can be a reasonable option. The use of FAP stabilizes the size of the aorta after a follow up of 53 months. Maintaining a size similar to the preoperative one avoids the complications related to the procedure.
28 Dec 2021Submitted to Journal of Cardiac Surgery
29 Dec 2021Submission Checks Completed
29 Dec 2021Assigned to Editor
29 Dec 2021Reviewer(s) Assigned
30 Dec 2021Review(s) Completed, Editorial Evaluation Pending
30 Dec 2021Editorial Decision: Revise Minor
03 Jan 20221st Revision Received
03 Jan 2022Submission Checks Completed
03 Jan 2022Assigned to Editor
03 Jan 2022Review(s) Completed, Editorial Evaluation Pending
03 Jan 2022Editorial Decision: Accept