<p><strong>Aim:</strong> Emphasis in this study was placed on clinical and functional assessment of a modified "Florida Sleeve" procedure during surgical correction of ascending aorta aneurysms with concomitant aortic insufficiency.<br /><strong>Methods:</strong> 32 patients with an aneurysm of the ascending aorta and aortic insufficiency underwent a modified "Florida Sleeve" procedure. The average follow-up was 17 (0-60) months. The average age of patients was 57±13 (23-73) years 56±13 years.<br /><strong>Results:</strong> The expected 4-year cumulative survival rate was 84.3%. Overall freedom from aortic insufficiency in the late period was 88.9%. Median aortic regurgitation was 1+ (1; 2). Long-term follow-up revealed no valve-associated complications.<br /><strong>Conclusion:</strong> The aortic root reimplantation procedure enables optimal correction of the existing lesions of the aortic root without performing aortic valve replacement and demonstrates stable clinical and functional outcomes in the long-term period.</p><p><strong>Key words:</strong> aortic aneurysm; aortic valve; valve-sparing operations.</p><p><strong>Funding</strong></p><p>The study had no sponsorship.</p><p><strong>Conflict of interest</strong></p><p>The authors declare no conflict of interest.</p>
<p><strong>Aim.</strong> Assessment of normal and variant aortic arch anatomy in patients with type A aortic dissection and aneurysm of the arch and descending thoracic aorta.</p><p><strong>Methods.</strong> We retrospectively studied computer tomography (CT) data of chest organs with contrast in patients who underwent reconstruction of the aortic arch in type I aortic dissection according to DeBakey classification (n = 61) and resection of the aortic arch and descending thoracic aorta aneurysm (n = 14) at the Meshalkin National Medical Research Center, Novosibirsk, Russian Federation. The control group included patients without aortic arch pathology (n = 52). To identify relationships between the anatomical type of aortic arch and the risk of aortic pathology development, univariate and multivariate binary logistic regression analyses were used.</p><p><strong>Results.</strong> Our analysis revealed four types of aortic arch anatomy. Normal aortic arch anatomy occurred in 66.1 % of patients (n = 84), the proportion of abnormalities of the left common carotid artery was 30 % (bovine aortic arch occurred in 15 %, and the same site of origin of left common carotid artery and brachiocephalic trunk occurred in 15 %). Divergence of the left vertebral artery from the aortic arch between the left common carotid and left subclavian arteries occurred in 3.1 % (n = 4), and the combination of “bovine trunk” and divergence of the left vertebral artery from the aortic arch was detected in 0.8 % patients (n = 1). Logistic regression analyses revealed no statistically significant relationships between variant aortic arch anatomy and the development of type A aortic dissections and aortic arch aneurysms. The presence of the common origin of brachiocephalic trunk and left common carotid artery was associated with a reduced risk of acute aortic dissection type I by 89 %, or an OR of 0.11 (95% CI: 0.03–0.46) (p = 0.002).</p><p><strong>Conclusion.</strong> Our data will help with future planning surgical interventions on the aortic arch and descending thoracic aorta.</p><p>Received 17 June 2020. Revised 16 July 2020. Accepted 17 July 2020.</p><p><strong>Funding:</strong> The study did not have sponsorship.</p><p><strong>Conflict of interest:</strong> Authors declare no conflict of interest.</p><p><strong>Author contributions</strong><br />Conception and design: A.A. Shadanov<br />Data collection and analysis: A.A. Shadanov, T.A. Bergen<br />Statistical analysis: D.A. Sirota, A.A. Shadanov<br />Drafting the article: A.A. Shadanov<br />Critical revision of the article: D.A. Sirota, M.M. Lyashenko, A.M. Chernyavskiy<br />Final approval of the version to be published: A.A. Shadanov, D.A. Sirota, T.A. Bergen, M.M. Lyashenko, A.M. Chernyavskiy</p>
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