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Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
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Residual and Progressive Aortic Regurgitation After Valve-Sparing Root Replacement: A Propensity-Matched

Fabian A Kari1, Kai-Nicolas Doll2, Wolfgang Hemmer2

  • 1Department of Cardiovascular Surgery, Heart Center Freiburg University, Freiburg, Germany.

The Annals of Thoracic Surgery
|December 26, 2015
PubMed
Abstract

Insights

Residual aortic regurgitation (rAR) and progressive aortic regurgitation (pAR) after valve-sparing aortic root replacement (V-SARR) are common. Early surgery before large aneurysms develop is recommended to minimize these risks.

Area of Science:

  • Cardiovascular Surgery
  • Cardiac Surgery Outcomes
  • Aortic Valve Repair

Background:

  • Residual/progressive aortic regurgitation (rAR, pAR) after valve-sparing aortic root replacement (V-SARR) can necessitate reoperations.
  • Identifying risk factors for rAR and pAR post-V-SARR is crucial for improving patient outcomes.
  • The impact of additional cusp repair on valve function requires further characterization.

Purpose of the Study:

  • To characterize risk factors associated with mild rAR and pAR following V-SARR in a multicenter cohort.
  • To analyze the effect of additional cusp repair on valve function after V-SARR using propensity matching.

Main Methods:

  • A multicenter cohort of 1,015 patients undergoing V-SARR was analyzed.
  • 764 patients with transthoracic echocardiography follow-up were included.
  • Logistic regression and propensity score matching were employed to identify risk factors and assess the impact of cusp repair.

Main Results:

  • The incidence of rAR was 29%, influenced by aneurysm size and preoperative valve function.
  • rAR was more frequent in nonsyndromic patients (34% vs. 14%).
  • Additional cusp repair was associated with new onset aortic regurgitation (AR) but not with rAR or pAR.

Conclusions:

  • Significant rates of rAR and pAR occur after V-SARR.
  • Operating on patients before large aneurysms form is advised.
  • While additional cusp repair may increase the risk of new onset AR, it does not appear to influence rAR or pAR.

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