ILM-FAN VA INNOVATSIYA
ILMIY-AMALIY KONFERENSIYASI
in-academy.uz/index.php/si
146
EXPERIENCE IN SURGICAL TREATMENT OF ASCENDING AORTIC
ANEURYSMS
Khusanboy Rakhimberganov
Tashkent Medical Academy
https://doi.org/10.5281/zenodo.15056287
Background
The diagnosis and surgical management of ascending aortic aneurysms remain among the
most challenging aspects of modern cardiovascular surgery. In 66.6% of cases, a standard one-
stage Bentall procedure was performed. Our experience also includes cases of ascending aortic
aneurysm associated with coarctation, and we aim to present our surgical approach and
outcomes.
Methods
Between January 1, 2010, and January 1, 2022, 41 patients with ascending aortic
aneurysms underwent the Bentall procedure at the Republican Specialized Center of Surgery.
The study cohort included 26 males (63%) and 15 females (37%), with ages ranging from 25
to 65 years (mean age: 31.6 ± 0.2 years).
The etiological factors included
Marfan syndrome
in 24 patients (58.5%),
atherosclerosis
in 14 patients (34.1%), and
degenerative aortic disease
in 3 patients (7.3%).
Aortic dissection (DeBakey Type II) was observed in 12 patients (29.2%), while 18 patients
(43.9%) underwent surgery without signs of dissection. Additionally,
bicuspid aortic valve
was identified in 8 cases (19.5%).
Three patients (7.3%) had an
ascending aortic aneurysm associated with coarctation
of the aorta
at a typical location. In these cases, a
two-stage surgical approach
was employed:
the first stage involved
resection of the coarctation with conduit replacement
, followed by
the
Bentall procedure 10–12 days later
, yielding excellent outcomes.
Results
The
hospital mortality rate
was 9.7% (4 patients), with causes of death including acute
heart failure, refractory postoperative bleeding, and multiple organ failure.
Conclusions
Despite certain complications and technical challenges, the
Bentall procedure
ensures
adequate radical correction of ascending aortic aneurysms. It demonstrates excellent
short-
and long-term survival rates
and a low incidence of reoperation. Therefore, this approach can
be recommended across a broad range of etiologies, including complex aortic pathologies such
as coarctation.
