Durability of Aortic Valve Cusp Repair With and Without Annular Support

Area of Science:

• Cardiovascular Surgery
• Cardiac Valve Repair
• Aortic Valve Dysfunction

Background:

• Assessing the long-term efficacy of aortic valve repair versus replacement.
• Evaluating various contemporary aortic valve repair techniques.

Purpose of the Study:

• To determine the value and late outcomes of aortic valve repair techniques.
• To identify factors influencing repair success and durability.

Main Methods:

• Analysis of 1,124 patients undergoing planned aortic valve repair between 2001-2011.
• Detailed assessment of multiple repair techniques including commissural sutures, cusp repair, and root procedures.
• Evaluation of in-hospital outcomes and long-term freedom from reoperation.

Main Results:

• Repair was aborted for replacement in 10% of patients, primarily due to severe aortic regurgitation (AR) and calcification.
• Long-term freedom from aortic valve reoperation was 90% at 10 years.
• Commissural figure-of-8 suspension sutures and annular support techniques demonstrated superior durability.
• 10-year AR severity was none/mild in 53% of patients, with root procedures associated with less severe postoperative AR.

Conclusions:

• Aortic valve repair is an effective and durable treatment for aortic valve dysfunction.
• Preoperative AR severity is a key predictor of repair failure.
• Techniques involving commissural figure-of-8 suspension sutures and annular support offer the best long-term outcomes.