Cochran and Verrier developed an algorithm for the repair of an aneurysm of the ascending aorta with or without aortic valve disease. The authors are from the Universities of Wisconsin and Washington (Seattle).
Parameters:
(1) Is the aortic valve salvagable?
(2) Can the patient tolerate long-term anticoagulation?
(3) Is the patient a good surgical risk, able to withstand a longer operative procedure?
Management options:
(1) aortic valve sparing with pseudosinus
(2) modified Bentall (valved conduit replacement of the aortic root to the transverse aortic arch)
(3) homograft
Aortic Valve Salvagable
Tolerate Anticoagulation
Good Surgical Risk
Management
Yes
Yes
NA
Bentall
Yes
No
Yes
valve sparing and pseudosinus
Yes
No
No
Bentall
No
Yes
NA
Bentall
No
No
NA
homograft
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