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Updated: May 23, 2026
14:14
Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
Published on: December 11, 2017
Mid-term results after sinutubular junction remodelling with aortic cusp repair
Mitsuru Asano1, Takashi Kunihara, Diana Aicher
1Department of Thoracic and Cardiovascular Surgery, University Hospital of Saarland, Homburg/Saar, Germany.
Summary
Sinutubular junction remodelling with aortic cusp repair is effective for ascending aortic aneurysms and significant aortic regurgitation. Dilated aortoventricular junction predicts reoperation, but the technique offers acceptable mid-term results.
Area of Science:
- Cardiovascular Surgery
- Aortic Surgery
- Aortic Valve Repair
Background:
- Ascending aortic aneurysms with aortic regurgitation (AR) often require surgical intervention.
- Sinutubular junction remodelling (STJR) with aortic cusp repair is an option when the aortic root diameter is preserved.
Purpose of the Study:
- To analyze the outcomes of STJR with aortic cusp repair in patients with ascending aortic aneurysms and significant AR.
- To evaluate the influence of valve morphology (tricuspid vs. non-tricuspid aortic valves) on outcomes.
Main Methods:
- Retrospective analysis of 144 patients undergoing STJR ± cusp repair for ascending aortic aneurysm and AR ≥ III between 1995 and 2010.
- Patients were divided into tricuspid aortic valve (TAV) and non-TAV groups.
- Mean follow-up was 25.9 months.
Main Results:
- Early mortality was 2.1%, with higher age predicting early death.
- Five-year survival was 93.9% overall (82.8% TAV, 98.5% non-TAV; P=0.02).
- Five-year freedom from recurrent AR ≥ III was 80.1% (97.0% TAV, 73.4% non-TAV; P=0.02).
- Five-year freedom from reoperation was 81.9% (97.0% TAV, 76.6% non-TAV; P<0.05).
- Dilated aortoventricular junction (AVJ > 28 mm) was a predictor for recurrent AR and reoperation.
Conclusions:
- STJR with cusp repair is a valuable technique for ascending aortic aneurysms with relevant AR.
- While a dilated AVJ poses a risk for recurrent AR and reoperation, concomitant cusp repair yields acceptable mid-term outcomes.
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