Abstract
Background Prosthetic replacement of aneurysms of the ascending aorta is the gold standard in
terms of long-term stability. Wrapping seems to be a less invasive procedure. It has
not yet been shown if it is as safe in terms of long-term outcome.
Methods We present a single-center analysis of our experience over 13 years. We retrospectively
analyzed data from patients who received either aortic prosthetic wrapping (AW) or
aortic prosthetic replacement (AR) with or without aortic valve replacement and assessed
them through phone calls. We used propensity score matching to adjust the baseline
of the groups.
Results Before propensity matching, 144 patients received AW and 91 patients underwent AR.
Mean age was 64 ± 11.8 years. After propensity score matching and adjusting for significant
differences in age, gender, body mass index, logistic EuroSCORE I, and left ventricular
function, 69 patients in each group remained for further analysis. Rate of early reoperation
due to tamponade, inhospital mortality, and survival rates did not differ. In both
groups, the surgically treated aortic segment did not show enlargement, whereas the
nontreated aortic arch showed comparable aneurysmatical progression.
Conclusions AW is safe and feasible and can be used in elderly or frail patients in order to
avoid an AR. Progression of the remaining native aortic segments occurs, thus requiring
strict life-long follow-up to ensure an elective and thus safe approach for appropriate
consecutive surgical measures, if required.
Keywords
aortic surgery - aneurysm - wrapping - aortic replacement - frailty
