[HSF] Ao Wraping

[Hgrmd at aol.com]

Dear Ajit,
  I hope some of the aortic big guns render an opinion on this  one.  As for 
me, I would have left it.  I don't think I've ever  intervened on an aorta 
less than 4.0 cm.  In addition, I've never heard of  recommendations to intervene 
on a 3.8 cm aorta in an adult.  The fact that  the aorta seemed reasonably 
thick and held sutures well would further support  conservative therapy. 
Wrapping the aorta may sound like a handy solution, but  I've never seen any 
literature that it is good therapy.  I'm sure this does  nothing toward preventing 
further dilatation of the sinuses.  I've read  that it can subsequently encroach 
on the coronary ostia.  In addition, if  the patient ever needs cardiac 
surgery in the future such as a CABG, I would  imagine that the technical 
difficulties would be considerable.  Again, I  have no experience in wrapping aortas or 
working on previously wrapped  aortas.
 
Hal



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