Vol. 26 No. 2 (2022)
REVIEWS

Wrapping of the ascending aorta: history and prospects

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  • V.A. Akulov,
  • S.A. Alsov,
  • D.A. Sirota,
  • M.M. Lyashenko,
  • A.M. Chernyavskiy
V.A. Akulov
Meshalkin National Medical Research Center, Novosibirsk
Bio
S.A. Alsov
Meshalkin National Medical Research Center, Novosibirsk; Novosibirsk State Medical University, Novosibirsk
D.A. Sirota
Meshalkin National Medical Research Center, Novosibirsk
M.M. Lyashenko
Meshalkin National Medical Research Center, Novosibirsk
A.M. Chernyavskiy
Meshalkin National Medical Research Center, Novosibirsk
Экзопротезирование восходящего отдела аорты цельным протезом
DOI: https://doi.org/10.21688/1681-3472-2022-2-30-37

Published 2022-06-30

Keywords

  • aneurysm,
  • aorta,
  • exoprosthetics,
  • wrapping

How to Cite

Akulov, V., Alsov, S., Sirota, D., Lyashenko, M., & Chernyavskiy, A. (2022). Wrapping of the ascending aorta: history and prospects. Patologiya Krovoobrashcheniya I Kardiokhirurgiya, 26(2), 30–37. https://doi.org/10.21688/1681-3472-2022-2-30-37

Copyright (c) 2022 Akulov V.A., Alsov S.A., Sirota D.A., Lyashenko M.M., Chernyavskiy A.M.

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Abstract

Historically, exoprosthetics is one of the first surgical procedures used for aneurysmal dilatation of such great vessels as the aorta. Despite the acceptable results of this method it is not widespread now because of the possible negative consequences of aortic wall wrapping (rupture or dissection).

According to the latest guidelines, it is necessary to consider prosthetics of the ascending aorta by the patients with aortic valve surgery and aneurysmal dilatation of the ascending aorta more than 45 mm. However, early postoperative mortality reaches 20 % by elderly patients with severe comorbidities. In such situations, it is worth to choose a less traumatic surgical approach. Exoprosthetics of the aorta reduces the invasiveness of procedure, time of artificial circulation and aortic occlusion thereby taking down the risks of early postoperative complications.

The purpose of this literature review is to analyze the current data on the technique of exoprosthetics of the aorta by the patients with moderate ascending aorta dilatation. The Scopus, Web of Science, PubMed databases were used for searching and selecting literature sources.

The results demonstrate that aortic wrapping is a safe method causing rapid and permanent aortic remodeling. The technique has comparable long-term results with prosthetics of the ascending aorta despite the presence of histological changes in the aortic wall with a changing in its mechanical properties.

Received 28 September 2021. Revised 19 January 2022. Accepted 20 January 2022.

Funding: This work was carried out within the framework of the state task of Ministry of Health of Russian Federation No. 121032300337-5.

Conflict of interest: Authors declare no conflict of interest.

Contribution of the authors
Conception and study design: S.A. Alsov, D.A. Sirota
Drafting the article: V.A. Akulov
Critical revision of the article: S.A. Alsov, D.A. Sirota, M.M. Lyashenko, A.M. Chernyavskiy
Final approval of the version to be published: V.A. Akulov, S.A. Alsov, D.A. Sirota, M.M. Lyashenko, A.M. Chernyavskiy

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References

  1. Lima B., Hughes G.C., Lemaire A., Jaggers J., Glower D.D., Wolfe W.G. Short-term and intermediate-term outcomes of aortic root replacement with St. Jude mechanical conduits and aortic allografts. Ann Thorac Surg. 2006;82(2):579-585. PMID: 16863768. https://doi.org/10.1016/j.athoracsur.2006.03.068
  2. Carrel T., von Segesser L., Jenni R., Gallino A., Egloff L., Bauer E., Laske A., Turina M. Dealing with dilated ascending aorta during aortic valve replacement: advantages of conservative surgical approach. Eur J Cardiothorac Surg. 1991;5(3):137-143. PMID: 2025439. https://doi.org/10.1016/1010-7940(91)90212-3
  3. Baumgartner H., Falk V., Bax J.J., de Bonis M., Hamm C., Holm P.J., Iung B., Lancellotti P., Lansac E., Rodriguez Muñoz D., Rosenhek R., Sjögren J., Tornos Mas P., Vahanian A., Walther T., Wendler O., Windecker S., Zamorano J.L. 2017 ESC/EACTS Guidelines for the management of valvular heart disease. Eur Heart J. 2017;38(36):2739-2791. PMID: 28886619. https://doi.org/10.1093/eurheartj/ehx391
  4. Williams J.B., Peterson E.D., Zhao Y., O’Brien S.M., Andersen N.D., Miller D.C., Chen E.P., Hughes G.C. Contemporary results for proximal aortic replacement in North America. J Am Coll Cardiol. 2012;60(13):1156-1162. PMID: 22958956; PMCID: PMC3699187. https://doi.org/10.1016/j.jacc.2012.06.023
  5. Zierer A., Melby S.J., Lubahn J.G., Sicard G.A., Damiano Jr R.J., Moon M.R. Elective surgery for thoracic aortic aneurysms: late functional status and quality of life. Ann Thorac Surg. 2006;82(2):573-578. PMID: 16863767. https://doi.org/10.1016/j.athoracsur.2006.03.042
  6. Robicsek F. A new method to treat fusiform aneurysms of the ascending aorta associated with aortic valve disease: an alternative to radical resection. Ann Thorac Surg. 1982;34(1):92-94. PMID: 7046664. https://doi.org/10.1016/s0003-4975(10)60860-0
  7. Gill M., Dunning J. Is reduction aortoplasty (with or without external wrap) an acceptable alternative to replacement of the dilated ascending aorta? Interact Cardiovasc Thorac Surg. 2009;9(4):693-697. PMID: 19602491. https://doi.org/10.1510/icvts.2009.213405
  8. Egloff L., Rothlin M., Kugelmeier J., Senning Å., Turina M. The ascending aortic aneurysm: replacement or repair? Ann Thorac Surg. 1982;34(2):117-124. PMID: 7103583. https://doi.org/10.1016/s0003-4975(10)60871-5
  9. Arsan S., Akgun S., Kurtoglu N., Yildirim T., Tekinsoy B. Reduction aortoplasty and external wrapping for moderately sized tubular ascending aortic aneurysm with concomitant operations. Ann Thorac Surg. 2004;78(3):858-861. PMID: 15337007. https://doi.org/10.1016/j.athoracsur.2004.03.101
  10. Чернявский А.М., Сирота Д.А., Альсов С.А., Хван Д.С., Ляшенко М.М. Экзопротезирование при аневризмах восходящего отдела аорты. Патология кровообращения и кардиохирургия. 2015;19(2):72-76. https://dx.doi.org/10.21688/1681-3472-2015-2-72-76 Cherniavsky A.M., Sirota D.A., Alsov S.A., Khvan D.S., Lyashenko M.M. Wrapping of ascending aortic aneurism. Patologiya krovoobrashcheniya i kardiokhirurgiya = Circulation Pathology and Cardiac Surgery. 2015;19(2):72-76. (In Russ.) https://dx.doi.org/10.21688/1681-3472-2015-2-72-76
  11. Hess P.J. Jr, Klodell C.T., Beaver T.M., Martin T.D. The Florida sleeve: A new technique for aortic root remodeling with preservation of the aortic valve and sinuses. Ann Thorac Surg. 2005;80(2):748-750. PMID: 16039256. https://doi.org/10.1016/j.athoracsur.2004.02.092
  12. Чернявский А.М., Хван Д.С., Альсов С.А., Сирота Д.А., Ляшенко М.М. Реимплантация корня аорты в протез: новый виток клапаносохраняющих операций. Патология кровообращения и кардиохирургия. 2016;20(2):49-57. https://dx.doi.org/10.21688/1681-3472-2016-2-49-57 Chernyavskiy A.M., Khvan D.S., Alsov S.A., Sirota D.A., Lyashenko M.M. Aortic root reimplantation procedure: a new milestone in aortic valve-sparing operations. Patologiya krovoobrashcheniya i kardiokhirurgiya = Circulation Pathology and Cardiac Surgery. 2016;20(2):49-57. (In Russ.) https://dx.doi.org/10.21688/1681-3472-2016-2-49-57
  13. Golesworthy T., Lampérth M., Mohiaddin R., Pepper J., Thornton W., Treasure T. The Tailor of Gloucester: A jacket for the Marfan’s aorta. Lancet. 2004;364(9445):1582. PMID: 15519627. https://doi.org/10.1016/s0140-6736(04)17308-x
  14. Treasure T. A ‘compare and contrast’ exercise: wrapping versus personalised external aortic root support (PEARS). J Cardiothorac Surg. 2016;11(1):104. PMID: 27406033; PMCID: PMC4942886. https://doi.org/10.1186/s13019-016-0499-7
  15. Pecoraro F., Shingaki M., Steuer J., Chaykovska L., Rancic Z., Weber A., Nguyen-Kim T.D.L., Bettex D., Veith F.J., Lachat M. Treatment of isolated ascending aortic aneurysm by off-pump epiaortic wrapping is safe and durable. Interact Cardiovasc Thorac Surg. 2016;23(2):286-291. PMID: 27083869. https://doi.org/10.1093/icvts/ivw103
  16. Nemec P., Pepper J., Fila P. Personalized external aortic root support. Interact Cardiovasc Thorac Surg. 2020;31(3):342-325. PMID: 32761056. https://doi.org/10.1093/icvts/ivaa111
  17. Cohen O., Odim J., de La Zerda D., Ukatu C., Vyas R., Vyas N., Palatnik K., Laks H. Long-term experience of girdling the ascending aorta with Dacron mesh as definitive treatment for aneurysmal dilation. Ann Thorac Surg. 2007;83(2):S780-S784. PMID: 17257926. https://doi.org/10.1016/j.athoracsur.2006.10.086
  18. Płonek T., Dumanski A., Nowicki R., Kustrzycki W. Computed tomography angiography of aorta subjected to external wrapping. J Cardiothorac Surg. 2016;11(1):89. PMID: 27245321; PMCID: PMC4888732. https://doi.org/10.1186/s13019-016-0487-y
  19. Plonek T., Rylski B., Dumanski A., Siedlaczek P., Kustrzycki W. Biomechanical analysis of wrapping of the moderately dilated ascending aorta. J Cardiothorac Surg. 2015;10:106. PMID: 26231405; PMCID: PMC4522071. https://doi.org/10.1186/s13019-015-0299-5
  20. Neri E., Massetti M., Tanganelli P., Capannini G., Carone E., Tripodi A., Tucci E., Sassi C. Is it only a mechanical matter? Histologic modifications of the aorta underlying external banding. J Thorac Cardiovasc Surg. 1999;118(6):1116-1118. PMID: 10595988. https://doi.org/10.1016/s0022-5223(99)70111-x
  21. Pepper J., Goddard M., Mohiaddin R., Treasure T. Histology of a Marfan aorta 4.5 years after personalized external aortic root support. Eur J Cardiothorac Surg. 2015;48(3):502-505. PMID: 25406424; PMCID: PMC4535558. https://doi.org/10.1093/ejcts/ezu415
  22. Plonek T. A metaanalysis and systematic review of wrapping of the ascending aorta. J Card Surg. 2014;29(6):809-815. PMID: 25195510. https://doi.org/10.1111/jocs.12448
  23. Lee S.H., Kim J.B., Kim D.H., Jung S.-H., Choo S.J., Chung C.H., Lee J.W. Management of dilated ascending aorta during aortic valve replacement: valve replacement alone versus aorta wrapping versus aorta replacement. J Thorac Cardiovasc Surg. 2013;146(4):802-809. PMID: 23856198. https://doi.org/10.1016/j.jtcvs.2013.06.007
  24. Ang K.-L., Raheel F., Bajaj A., Sosnowski A., Galiñanes M. Early impact of aortic wrapping on patients undergoing aortic valve replacement with mild to moderate ascending aorta dilatation. J Cardiothorac Surg. 2010;5:58. PMID: 20691060; PMCID: PMC2922107. https://doi.org/10.1186/1749-8090-5-58
  25. Park J.Y., Shin J.-K., Chung J.W., Kim J.S., Chee H.K., Song M.-G. Short-term outcomes of aortic wrapping for mild to moderate ascending aorta dilatation in patients undergoing cardiac surgery. Korean J Thorac Cardiovasc Surg. 2012;45(3):148-154. PMID: 22708081; PMCID: PMC3373969. https://doi.org/10.5090/kjtcs.2012.45.3.148
  26. Plonek T., Dumanski A., Nowicki R., Kustrzycki W. Single center experience with wrapping of the dilated ascending aorta. J Cardiothorac Surg. 2015;10:168. PMID: 26589143; PMCID: PMC4654867. https://doi.org/10.1186/s13019-015-0371-1
  27. Choi M.S., Jeong D.S., Lee H.Y., Sung K., Kim W.S., Lee Y.T., Park P.W. Aortic wrapping for a dilated ascending aorta in bicuspid aortic stenosis. Circ J. 2015;79(4):778-784. PMID: 25740349. https://doi.org/10.1253/circj.cj-14-0933
  28. Zhang H., Lu F., Qu D., Han L., Xu J., Ji G., Xu Z. Treatment of fusiform ascending aortic aneurysms: a comparative study with 2 options. J Thorac Cardiovasc Surg. 2011;141(3):738-743. PMID: 20584536. https://doi.org/10.1016/j.jtcvs.2010.05.031
  29. Treasure T., Petrou M., Rosendahl U., Austin C., Rega F., Pirk J., Pepper J. Personalized external aortic root support: A review of the current status. Eur J Cardiothorac Surg. 2016;50(3):400-404. PMID: 27032474. https://doi.org/10.1093/ejcts/ezw078
  30. Robicsek F., Cook J.W., Reames Sr M.K., Skipper E.R. Size reduction ascending aortoplasty: is it dead or alive? J Thorac Cardiovasc Surg. 2004;128(4):562-570. PMID: 15457157. https://doi.org/10.1016/j.jtcvs.2004.04.032
  31. Izgi C., Newsome S., Alpendurada F., Nyktari E., Boutsikou M., Pepper J., Treasure T., Mohiaddin R. External aortic root support to prevent aortic dilatation in patients with Marfan syndrome. J Am Coll Cardiol. 2018;72(10):1095-1105. PMID: 30165980. https://doi.org/10.1016/j.jacc.2018.06.053
  32. Belov I.V., Stepanenko A.B., Gens A.P., Savichev D.D., Charchyan E.R. Reduction aortoplasty for ascending aortic aneurysm: a 14-year experience. Asian Cardiovasc Thorac Ann. 2009;17(2):162-166. PMID: 19592547. https://doi.org/10.1177/0218492309103302
  33. Lopez S., Roux D., Cazavet A., Tapia M., Teboul J., Leobon B., Glock Y. Wrapping procedure for Stanford type A acute aortic dissection: is there an indication for surgery without a cardiopulmonary bypass? Ann Thorac Surg. 2012;94(3):990-991. PMID: 22580172. https://doi.org/10.1016/j.athoracsur.2011.12.083
  34. Demondion P., Ramadan R., Azmoun A., Raoux F., Angel C., Nottin R., Deleuze P. Aortic wrapping for Stanford type A acute aortic dissection: short and midterm outcome. Ann Thorac Surg. 2014;97(5):1590-1596. PMID: 24518574. https://doi.org/10.1016/j.athoracsur.2013.11.052