Isolated Ascending Aortic Aneurysms: Five-Year Comparative Outcomes between Modified Wrapping Technique and Supracoronary Tube Replacement.

PURPOSE: This study aimed to compare outcomes of the modified wrapping technique (MWT) and supracoronary tube replacement (STR) for isolated ascending aortic aneurysms, focusing on perioperative safety, 5-year survival, and arterial stiffness.

METHODS

This retrospective, single-center study included 205 patients undergoing MWT (n = 91) or STR (n = 114) between 2006 and 2019 for isolated ascending aortic aneurysms ≥50 mm or rapidly progressing lesions. A prospective substudy evaluated arterial stiffness using the SphygmoCor system in a matched subgroup of 40 patients. The primary endpoint was 5-year survival; secondary endpoints included perioperative outcomes, prosthetic infection, and hemodynamic indices.

RESULTS

MWT showed significantly shorter cardiopulmonary bypass and aortic cross-clamp times (p <0.0001) and reduced hospital stay (10.5 ± 0.3 vs. 13.5 ± 0.8 days; p = 0.001). In-hospital mortality tended to be lower with MWT (0% vs. 4.4%; p = 0.06). Five-year survival was comparable between groups (88.1% vs. 83.4%; p = 0.17). Prosthetic infection was significantly lower in the MWT group (1.1% vs. 7.0%; p = 0.04). Hemodynamic assessment demonstrated lower pulse wave velocity and aortic augmentation index in the MWT group.

CONCLUSIONS

MWT was associated with shorter operative times and lower prosthetic infection rates while maintaining similar early and mid-term survival compared with STR. These findings suggest MWT as a valuable alternative in selected patients.