[An evaluation of aortic root reconstruction using Carrel patch method with coronary anastomosis].

During the past 4 years, from January 1991 to December 1994, we experienced 12 cases of aortic root reconstruction utilizing Carrel patch method. The cases included annulo-aortic ectasia (AAE), root aneurysm with aortic regurgitation (AR), and aortic dissection with AR. The aortic valve and aortic root were resected, the coronary ostia were dissected free, mobilized, and then implanted to the composite graft. Coronary anastmosis was performed by mattress suture and reinforced by Tefron felt strips. It was necessary in one case to undergo coronary artery bypass grafting for myocardial ischemia due to coronary ostial stenosis. Operative procedure could be performed in 4 cases without blood transfusion. Post operative death was seen in only 1 case at 25 postoperative day, who underwent on emergency operation for cardiac tamponade due to aortic dissection. Pseudoaneurysm formations of coronary ostia or hospital death was not observed in any other cases during follow up period (average 25 months). Late tamponade was shown in one case as a complication, and the majority of cases had uneventful postoperative course. The operative procedure is considered feasible in any anatomic variation of the aortic root disease, even if dislocation of coronary ostia is minimal, and can be expect for prevention of pseudoaneurysm formation, and long term survival.