Aortic valve-sparing operations for aortic root aneurysm

The object of this report is to review the clinical outcomes of aortic valve-sparing operations in patients with aortic root aneurysm. From May 1988 to June 2000, 120 patients with aortic root aneurysm with or without aortic insufficiency underwent aortic valve-sparing operations. There were 83 men and 37 women whose mean age was 46 years (range 16 to 72 years). Forty-eight patients had the Marfan syndrome, and 22 had either acute or chronic type A aortic dissections. Reconstruction of the aortic root was performed using the technique of reimplanation of the aortic valve in 64 patients and the remodeling of the aortic root in 56. The mean follow-up was 35 months (range 2 to 145 months), and it was complete. Aortic valve function was assessed by echocardiography. There were 2 operative and 5 late deaths. The 10-year survival for patients with aortic root aneurysm was 88% +/- 4%. Two patients have required aortic root replacement: one on the first postoperative day because of severe aortic insufficiency and one paraplegic patient 12 years after surgery because of infective endocarditis with aortic root abscess. Both patients survived reoperation. The 10-year freedom from aortic root reoperation was 99% +/- 1%. Three patients suffered transient ischemic attacks. The 10-year freedom from thromboembolic events was 89% +/- 5%. Seven patients had moderate aortic insufficiency at the latest echocardiographic study. The 10-year freedom from severe or moderate aortic insufficiency was 83% +/- 8%. Aortic valve-sparing operations have provided excellent clinical outcomes and few valve-related complications. The function of the reconstructed aortic root remains unchanged in most patients during the first decade of follow-up.