Surgical experience with "waistcoat aortoplasty": an update

Area of Science:

• Cardiovascular Surgery
• Aortic Diseases
• Aortic Valve Disease

Background:

• Aortic valve disease can cause asymmetrical dilation of the aortic root and ascending aorta.
• Waistcoat aortoplasty is a surgical technique used in specific cases of aortic dilation.
• This study reports updated results from 73 waistcoat aortoplasty procedures.

Purpose of the Study:

• To evaluate the efficacy of waistcoat aortoplasty in patients with primary aortic valve disease and associated aortic dilation.
• To assess the short-term and mid-term outcomes of the procedure.

Main Methods:

• Seventy-three patients underwent aortic valve replacement combined with waistcoat aortoplasty.
• The technique involves plicating redundant aortic wall and reconstructing the aorta with a double-layer technique.
• Echocardiography was used for pre- and post-operative assessments, with follow-up every six months.

Main Results:

• The procedure had no hospital mortality and low postoperative morbidity.
• Significant reduction in aortic root, sinotubular junction, and ascending aorta diameters was observed post-procedure (p < 0.001).
• No significant increase in aortic diameters was noted during a mean follow-up of 39.2 months.

Conclusions:

• Waistcoat aortoplasty is a safe and effective procedure for managing asymmetrical aortic dilation secondary to aortic valve disease.
• The technique provides stable aortic dimensions in the mid-term follow-up.
• Further long-term studies are warranted, but the procedure should be considered in relevant clinical scenarios.