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Related Concept Videos

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Endoscopy is a non-surgical medical technique used to examine a person's internal organs and vessels. This lesson will focus on two types of endoscopic studies: bronchoscopy and thoracoscopy.
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David operation: single center 10-year experience.

P G Malvindi1, A Cappai, A Basciu

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Aortic valve-sparing operations show excellent durability, especially with tricuspid valves. Cusp repair complications can lead to early failure, necessitating reoperation.

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Area of Science:

  • Cardiovascular Surgery
  • Cardiac Surgery
  • Aortic Valve Surgery

Background:

  • Aortic valve-sparing operations are increasingly performed for aortic root aneurysm.
  • The procedure is now considered for bicuspid aortic valves, severe aortic regurgitation, and aortic dissection.
  • This study evaluates a decade of experience with valve reimplantation and mid-term echocardiographic follow-up.

Purpose of the Study:

  • To assess the mid-term durability and outcomes of aortic valve-sparing operations with valve reimplantation.
  • To identify risk factors for reoperation after aortic valve-sparing surgery.
  • To compare outcomes in patients with bicuspid versus tricuspid aortic valves.

Main Methods:

  • A total of 139 patients underwent aortic valve-sparing operation with valve reimplantation between 2002 and 2012.
  • Twenty-seven patients had bicuspid aortic valves, and 18 required adjunct cusp repair.
  • All patients received a Gelweave Valsalva™ graft.

Main Results:

  • The 8-year survival rate was 87%.
  • Freedom from reoperation due to aortic regurgitation was 86% at 8 years.
  • Reoperation rates were similar for bicuspid and tricuspid valves, but higher in patients who underwent cusp repair.

Conclusions:

  • Valve reimplantation demonstrates excellent durability in patients with tricuspid aortic valves and normal cusps.
  • Cusp prolapse and complications from cusp repair are primary causes of early valve failure.
  • Careful patient selection and technique are crucial for long-term success.