Wheat Operation

Aneurysm is the most common condition of the thoracic aorta that requires surgical treatment. This pathological condition can lead to an increased risk of aortic wall free rupture or acute aortic dissection, both burdened with high mortality rate. According to the last European Guidelines surgery is indicated in patients who have an ascending aorta diameter more than 55 mm, with lower threshold in presence of elastopathy or bicuspid aortic valve with risk factors associated. If there's an aortic valve disease (severe regurgitation or stenosis) associated an aortic valve replacement (AVR) is performed at the same time.

In case of an aneurysm limited to the ascending aorta, over the sino-tubular junction, the aneurysmal segment is excised and replaced with a tube graft. The aortic valve cusps are also excised and replaced with a bioprosthetic or a mechanical valve. The surgery is performed in Cardiopulmonary Bypass assistance, cross-clamping the Aorta, over the aneurysmal segment, with cardioplegic arrest of the heart. The surgical approach of the ascending aorta can be performed either with a  traditional full median sternotomy or, in selected cases, witha a partial upper sternotomy.