Prospective evaluation of the extensibility of the ascending aorta wall and its vascular prosthesis in a patient with an aneurysm with technically flawless surgical correction and postoperative decrease in functional parameters. Clinical case and literature review.

A clinical case is presented and discussed when a patient with an instrumentally detected ascending aortic aneurysm with an expansion of the lumen up to 60 mm, after performing surgically flawless prosthetics, there was a marked decrease in exercise tolerance, a decrease in the contractile function of the left ventricular myocardium at rest, and an expansion of the pulmonary artery. It is shown that the leading factor was a decrease in the volume of systolic expansion of the aorta down to 5 ml, at the initial 13 ml, despite a noticeable increase in extensibility and a decrease in mechanical stiffness compared with initial indexes of the affected aortic wall. In this connection, the problems of creating aortic prostheses equivalent in terms of mechanical extensibility and elasticity to those for healthy biological tissues are discussed.