OBJECTIVES: The aim of this study was to assess the impact of aortic valve morphology and different surgical aortic valve repair techniques on long-term clinical outcomes. METHODS: Between February 2003 and May 2010, 216 patients with aortic insufficiency underwent aortic valve repair in our institution. Ages ranged between 26 and 82 years (mean 53 ± 15 years). Aortic valve dysfunctions, according to functional classification, were: type I in 55 patients (25.5%), type II in 126 (58.3%) and type III in 35 (16.2%). Sixty-six patients (27.7%) had a bicuspid valve. Aortic valve repair techniques included sub-commissural plasty in 138 patients, plication in 84, free-edge reinforcement in 80, resection of raphe plus re-suturing in 40 and the chordae technique in 52. Concomitant surgical procedures were CABG in 22 (10%) patients, mitral valve repair in 12 (5.5%), aortic valve-sparing re-implantation in 78 (36%) and ascending aorta replacement in 69 (32%). Mean follow-up was 42 ± 16 months and was 100% complete. RESULTS: There were six early deaths (2.7%). Overall late survival was 91.5% (18 late deaths). There were 15 (6.9%) late cardiac-related deaths. NYHA functional class was ≤ II in all patients. At follow-up, 28 (14.5%) patients had recurrent aortic insufficiency ≥ grade II. The freedom from valve-related events was significantly different between bicuspid and tricuspid valve implantation (P < 0.01), between type I + II and type III (P < 0.001) dysfunction and between the chordae technique and plication, compared to free-edge reinforcement (P < 0.01). Statistically-significant differences were found between patients who underwent aortic valve repair plus root re-implantation, compared to those who underwent isolated aortic valve repair (P = 0.02). CONCLUSIONS: Aortic valve repair including aortic annulus stabilization is a safe surgical option with either tricuspid or bicuspid valves; even more so if associated with root re-implantation. Patients with calcified bicuspid valves have poor results.
OBJECTIVES: The aim of this study was to assess the impact of aortic valve morphology and different surgical aortic valve repair techniques on long-term clinical outcomes. METHODS: Between February 2003 and May 2010, 216 patients with aortic insufficiency underwent aortic valve repair in our institution. Ages ranged between 26 and 82 years (mean 53 ± 15 years). Aortic valve dysfunctions, according to functional classification, were: type I in 55 patients (25.5%), type II in 126 (58.3%) and type III in 35 (16.2%). Sixty-six patients (27.7%) had a bicuspid valve. Aortic valve repair techniques included sub-commissural plasty in 138 patients, plication in 84, free-edge reinforcement in 80, resection of raphe plus re-suturing in 40 and the chordae technique in 52. Concomitant surgical procedures were CABG in 22 (10%) patients, mitral valve repair in 12 (5.5%), aortic valve-sparing re-implantation in 78 (36%) and ascending aorta replacement in 69 (32%). Mean follow-up was 42 ± 16 months and was 100% complete. RESULTS: There were six early deaths (2.7%). Overall late survival was 91.5% (18 late deaths). There were 15 (6.9%) late cardiac-related deaths. NYHA functional class was ≤ II in all patients. At follow-up, 28 (14.5%) patients had recurrent aortic insufficiency ≥ grade II. The freedom from valve-related events was significantly different between bicuspid and tricuspid valve implantation (P < 0.01), between type I + II and type III (P < 0.001) dysfunction and between the chordae technique and plication, compared to free-edge reinforcement (P < 0.01). Statistically-significant differences were found between patients who underwent aortic valve repair plus root re-implantation, compared to those who underwent isolated aortic valve repair (P = 0.02). CONCLUSIONS: Aortic valve repair including aortic annulus stabilization is a safe surgical option with either tricuspid or bicuspid valves; even more so if associated with root re-implantation. Patients with calcified bicuspid valves have poor results.
Authors: Jean-Benoît le Polain de Waroux; Anne-Catherine Pouleur; Céline Goffinet; David Vancraeynest; Michel Van Dyck; Annie Robert; Bernhard L Gerber; Agnès Pasquet; Gébrine El Khoury; Jean-Louis J Vanoverschelde Journal: Circulation Date: 2007-09-11 Impact factor: 29.690
Authors: Tirone E David; Christopher M Feindel; Gary D Webb; Jack M Colman; Susan Armstrong; Manjula Maganti Journal: J Thorac Cardiovasc Surg Date: 2006-07-10 Impact factor: 5.209
Authors: Kenji Minakata; Hartzell V Schaff; Kenton J Zehr; Joseph A Dearani; Richard C Daly; Thomas A Orszulak; Francisco J Puga; Gordon K Danielson Journal: J Thorac Cardiovasc Surg Date: 2004-03 Impact factor: 5.209
Authors: Khalil Fattouch; Roberta Sampognaro; Giuseppe Bianco; Emiliano Navarra; Marco Moscarelli; Giuseppe Speziale; Giovanni Ruvolo Journal: Ann Thorac Surg Date: 2008-06 Impact factor: 4.330