Redo operations for recurrent XXXX of the ascending aorta and transverse aortic arch.

@entity1 @entity3665 @entity384 @entity1614 @entity886 @entity439 @entity179 @entity337 @entity453 @entity1580
Sixty-seven operations were performed in 59 @entity1 for @entity439 occurring after previous operations involving the ascending aorta and transverse aortic arch. The initial aortic pathological condition included the following: @entity439 due to @entity179 in 34 @entity1 , 12 of whom had @entity1614 ; @entity1580 in a previously undilated aorta in 23; and @entity439 persisting or occurring after brachiocephalic bypass in 2. One of the latter had an @entity439 because of @entity3665 . Various operations initially performed did not completely treat the disease, and certain complications occurred spontaneously, including infection and dissection. The residual pathological condition led to the development of @entity337 , @entity1580 , @entity453 , and progressive @entity384 . These complications were treated by composite valve graft replacement of the aortic valve and ascending aorta or the transverse aortic arch or both, simple @entity886 , graft replacement of the ascending aorta or arch or both, and suture of false @entity439 with viable tissue wrap. Twenty @entity1 (34%) had an @entity439 of the distal aorta. The entire aorta was replaced in 3, thoracoabdominal segments in 9, and the abdominal aorta in 1. Of the 59 @entity1 , 49 (83%) were early survivors and 40 (68%) were alive on January 1, 1985. Principles of therapy that may have prevented the complications leading to reoperation include @entity439 replacement at the time of @entity886 and coronary artery bypass; total replacement of the ascending aorta and aortic valve in @entity1 with @entity1614 ; the same procedure or @entity886 and separate graft replacement in @entity1 with non-Marfan's @entity179 ; ascending aortic replacement in all @entity1 with dissection combined with valve resuspension, @entity886 , or composite valve graft depending on the involvement of the aortic sinuses and the presence of @entity337 .
