Ascending aortic aneurysm resection: 15 years' experience.

Between September 1989 and June 2004, 148 consecutive patients underwent ascending aortic replacement for aneurysm or dissection. There were 130 males (88%) and 18 females (12%). Their mean age was 46.20 +/- 13.36 years. Fifty-seven patients (39%) were treated for type 1 and type 2 aortic dissection, and 91 (61%) for ascending aortic aneurysm. The Bentall procedure was performed in 81 patients (55%), the Cabrol procedure in 7 (5%), separate ascending aortic replacement and aortic valve replacement or repair was carried out in 24 (16%), and ascending aortic replacement only in 36 (24%). Hospital mortality was 4.05% (6 deaths). On univariate analysis, left ventricular ejection fraction < or = 30%, emergency surgery, contained rupture, concomitant coronary artery bypass grafting, and age > or = 65 years were risk factors for early mortality. However, on multivariate analysis, ejection fraction < or = 30% and contained rupture were the only factors significantly associated with early mortality. The long-term survival rates were 87.2% +/- 3.7% at 5 years, 78.0% +/- 5.6% at 10 years, and 60.9% +/- 9.9% at 15 years. Ascending aortic resection for aneurysm or dissection can be performed with low mortality and morbidity.