Present status of reconstructive surgery for aortic valve disease.

Most surgical techniques for reconstruction of the aortic valve, although described a long time ago, are now feasible with satisfactory results. The general surgical principles for successful reconstruction, and the operative techniques of annuloplasty, commissurotomy, free edge resuspension, unrolling and thinning, and cusp extension are described. Methods for intraoperative evaluation of the repaired valve are also described. Between August 1988 and April 1992, 166 patients underwent aortic valve reconstruction with a 3.2% hospital and 1.2% late mortality. There were no thromboembolic events in the patients with isolated aortic valve repair. The reoperation rate was 6.5%. Echocardiographic study at last follow-up showed stable results at 4 years maximum follow-up.