A method of repair for asymmetric aneurysmal dilatation of the ascending aorta

The repair technique for an ascending aortic aneurysm depends on the portion of the aorta involved. An aneurysm in which the geometry of the sinotubular junction and the distal ascending aorta is preserved has classically been treated with resection and replacement with tube graft. We report an alternate method of resection of asymmetric aneurysmal dilatation of the ascending aorta with primary end-to-end anastomosis and our results of this approach with 14 patients. This method allows for complete resection of the aneurysm and tension-free anastomosis; it requires only one suture line and theoretically reduces the risk of bleeding. The endothelial surface of the aorta is preserved without an interposed synthetic graft. This method can be performed safely and the repair is durable at intermediate-term follow-up.