Objective: The aim of this study was evaluation of different surgical strategies of ascending aortic aneurysm repair in children and young adults.
Methods: From August 2003 to August 2008, 35 patients aged 7 to 35 (mean 21) years presented with ascending aortic aneurysm. In 18 patients, the aneurysm was a primary lesion (Group A), whereas in 17 patients, aortic aneurysm developed after surgical and/or catheter interventions for congenital heart disease (Group B).
Results: Surgical procedures included aortic valve sparing operation (6 patients in Group A vs.2 patients in Group B), conduit replacement (10 vs.11), and ascending aortic replacement (2 vs.4). Mean cardiopulmonary bypass and aortic cross-clamp time were 137 ± 24 vs. 241 ± 116 min (p=0.02) and 86 ± 20 vs. 98 ± 32 min (p=0.19) in Group A and Group B, respectively. One patient in Group B died on the 16th postoperative day. The other 34 patients survived the operation and are in New York Heart Association functional class II or less at maximum of 5 years follow-up. Actuarial survival was 97.3% at 5 years, and all patients were free from reoperation. There was only one thromboembolic complication. Aortic valve function was good in all 8 patients after valve sparing operation.
Conclusions: Ascending aortic aneurysm in children and young adults was surgically treated with excellent mid-term outcome. Conduit implantation is the gold standard in children and young adult and showed good results. Aortic valve sparing operation showed encouraging results with acceptable valve function for selected patients.