Anyone had a "Reduction Aortoplasty"?

[Bad Mad]

I understand this a preservation technique to treat a moderately (or small) sized ascending aortic aneurysm (less than 5.5cm), with no other root dilatation. I had never heard of it until yesterday, when still baffled as to what exactly the surgeon did to my AAA in surgery 6 weeks ago, I realised that this is perhaps what he done!!

I was in for AV replacement and +/- root replacement. Looking very much like a bentalls. To my shock/confusion I was told post op that my Ascending Aorta had been preserved. The intricacies were explained but no name put on it.

I understand this is a controversial but safe procedure that surgeons are very divided on. Long and short term results seem to be good, again depending on the suitability of the patient, and the make up of their aortic walls etc. etc.

Has anyone here had this procedure to treat their aneurysm? Just curious

 

[Magic8Ball]

I think this is where they do some work on the ascending aorta and then wrap that with some additional support.

I could be entirely wrong but a quick google search seemed to indicate that was the case.

My understanding is that this was an older procedure that wasn't done much anymore....sorry to put a seed of doubt or worry in your head....but i guess there could be an updated version of this.

At one point in time i think they used to do the dacron graft and then wrap the old aorta around it but this doesn't sound like what you have had done.

I guess the best bet is to speak with the surgeon again and find out exactly what was done and ask why....they make yourself aware of any possible benefits or shortfalls of that method.

As you can see from my signature i had a bentalls and i guess everyone convinces themselves that they chose the best solution so there is some danger that my lack of enthusiasm for what i think has been done is not entirely warranted.

Looking at the link below which was one of the google results it refers to the the procedure as controversal but also says that outcomes are good.

http://www.blackwell-synergy.com/doi/abs/10.1111/j.1540-8175.2007.00417.x


Regards.

 

[Bad Mad]

Yeh thats what I understood, although the operation is also done without any darcon wrapping, which i think I had done.

No Worries MB. Ive come across a few studies on it's effectiveness, and it seems to have still been used a couple of years ago at least. (1998 - 2005). Many surgeons seem to be against it because of the potential for redilatation.

One piece of lieterature says:

"RAA without external wrapping shows good long-term results in patients with a dilated ascending aorta who underwent concomitant cardiac procedures.....Moreover, ascending aortoplasty without external wrapping preserves the important elastic properties, namely the Windkessel functon."

I suppose it horses for courses. I think my surgeon talked about my aortic walls being strong and having good elasticity. he also said something about my homograft being responsible for the dilatation. Mechanical valve in, regurgiatation/stenosis gone, problem solved was the jist of what he told me.
(and of course he spoke of some sort of trimming around the ascending aorta.)

Really it probably comes down to the judgement of the surgeon, and his preferred technique.

 

[Magic8Ball]

Yep, there are certainly lots of variables and we don't understand them all.

Another favorite saying....

"Just because i've had my car serviced it doesn't make me a mechanic "

My aortic walls were certainly shot and there was no misunderstanding about my need for the full bentalls.

I guess as long as you keep up with the checks any change in circumstances can be rectified.

Good luck with your continued recovery.

 

[Bad Mad]

I see that couple of people on the forum have had the procedure done.

One (Annie I think) has had problems with re-dilatation
I suppose the flip side is, if the surgeon makes the right call then preserving
your own aorta has to be a good thing; and protecting you from further invasive surgery has to be positive.

I'll not get too far ahead of myself until I find out for sure that's what he done. Each case on it's own merit. My surgeon is the only recognised Aortic Valve specialist in the NORTH (Ireland), so I "trust" he knew what he was doing!!

 

[Ross]

Doesn't ring a bell to me. Something else to learn about I guess.

 

[daveh]

Bad Mad,

Regarding your aorta, did your surgeon or cardiologist give you any restrictions on competitive athletics (such as sprinting during a game) after you had the aortoplasty? I had a mechanical aortic valve put in four weeks ago, and the surgeon said my dilated ascending aorta (4.2) looked healthy and he did an aortoplasty reduction rather than replacing it. Prior to surgery the cardiologist felt that I should not go all out when running or cycling because of the dilated aorta. I will ask about restrictions during my followup with the surgeon and cardiologist, but I am curious as to what your doctors said about going all out during athletic activity.

Thanks,
Dave