JUAN CRESTANELLO: Welcome to the Cardiovascular Surgery Series where I discuss the latest research in cardiovascular surgery from the Mayo Clinic in just 2 minutes. I am Dr. Juan Crestanello, and I am a cardiac surgeon at the Mayo Clinic in Rochester, Minnesota.
I will review today the article published in the Journal of Thoracic and Cardiovascular Surgery in 2019. It is entitled "Open a hemiarch versus clamped ascending aorta replacement for aortopathy during initial bicuspid aortic valve replacement."
The extent of the distal aortic resection at the time of ascending aorta replacement for aneurysms related to bicuspid aortic valve is controversial. Some surgeons advocate hemiarch arch replacement while others recommend resection limited to the ascending aorta. We reviewed 700 patients with bicuspid aortic valve who had replacement of the ascending aorta. 70% has replacement limited to the ascending aorta while 30% had ascending aorta and hemiarch replacement.
Surgery was longer in the hemiarch group and required more blood transfusions. Operative mortality was less than 1% in both groups. After six years of follow up, survival was similar in both groups. No cases of repeat arch operations were identified during the follow up period. We conclude that during the limited follow up time of the study, we identified no advantage of performing hemiarch replacement in the absence of an aortic arch dilatation. Thank you for listening to the Mayo Clinic Cardiovascular Surgery Series.