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Updated: May 23, 2026
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Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
Published on: December 11, 2017
Complex aortic valve surgery for endocarditis using the beating-heart technique
Marco Ricci1, Maria R Suarez, Anthony L Panos
1From the Division of Cardiothoracic Surgery, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine and Jackson Memorial Hospital, Miami, FL USA.
Innovations (Philadelphia, Pa.)
|March 23, 2012
Summary
Beating-heart aortic valve surgery for endocarditis may preserve left ventricular (LV) function without improving survival compared to traditional methods. This technique offers an alternative myocardial protection strategy for complex cases.
Area of Science:
- Cardiovascular Surgery
- Cardiac Surgery
- Thoracic Surgery
Background:
- Aortic valve surgery for endocarditis is associated with poor outcomes.
- Postoperative left ventricular (LV) dysfunction can worsen outcomes.
- Conventional myocardial protection strategies may be suboptimal in these complex cases.
Purpose of the Study:
- To evaluate the initial clinical experience of a beating-heart technique for aortic valve surgery in patients with endocarditis.
- To assess the impact of this technique on myocardial function preservation.
- To report surgical outcomes and complications associated with this approach.
Main Methods:
- A cohort of 30 consecutive patients with endocarditis underwent aortic valve repair or replacement using a beating-heart technique.
- Prosthetic options included mechanical and biologic valves.
- Patients presented with various comorbidities and complex valve pathologies, including severe insufficiency, vegetations, annular abscesses, and fistulas.
Main Results:
- The study included 30 patients (22 men, 8 women; mean age 52.8 years) with diverse comorbidities and valve conditions.
- Early mortality was 13.3% and late mortality was 10%, with higher mortality in salvage operations (42%).
- No significant difference in LV function (ejection fraction, fractional shortening) was observed pre- and postoperatively, though LV end-diastolic dimension decreased.
Conclusions:
- Beating-heart aortic valve surgery did not demonstrate improved survival compared to historical conventional methods.
- This technique serves as a viable alternative for myocardial protection, potentially preserving LV function in complex aortic valve endocarditis surgeries.
- Further research is needed to establish long-term survival benefits.
