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Aortic valve sparing operations: an update.

T E David1, S Armstrong, J Ivanov

  • 1Division of Cardiovascular Surgery, The Toronto Hospital, University of Toronto, Ontario, Canada. aats@torhosp.toronto.on.ca

The Annals of Thoracic Surgery
|July 3, 1999
PubMed
Summary
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Aortic valve sparing operations for ascending aorta and root aneurysms show excellent long-term results. These valve-sparing procedures are feasible and durable for patients with normal or near-normal aortic leaflets.

Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Aortic Surgery

Background:

  • Aortic valve sparing operations for ascending aorta/root aneurysms have been performed for a decade.
  • Initially, only patients with normal aortic valve leaflets were candidates.
  • The procedure has expanded to include patients with leaflet prolapse and bicuspid aortic valves.

Purpose of the Study:

  • To update the clinical results of aortic valve sparing operations.
  • To evaluate the feasibility and durability of these procedures in a broader patient population.

Main Methods:

  • 126 patients with ascending aorta/root aneurysms and aortic insufficiency underwent valve-sparing surgery from 1988-1997.
  • Procedures included sinotubular junction adjustment, sinus replacement, or aortic valve reimplantation.

Related Experiment Videos

  • Associated conditions included Marfan syndrome, aortic dissection, and coronary artery disease.

    • Main Results:

    • 3 operative deaths occurred; 11 late deaths (7 cardiovascular).
    • Actuarial survival was 72% at 7 years.
    • Freedom from aortic valve replacement was 97% at 7 years, with most patients experiencing mild or no aortic insufficiency.

    Conclusions:

    • Aortic valve sparing operations are feasible for patients with ascending aorta/root aneurysms and normal or near-normal aortic leaflets.
    • The functional results of repaired aortic valves are excellent.
    • The aortic valve repair demonstrates durability in long-term follow-up.