Short-term competency of aortic valve repair in Egyptian patients

In recent years, repair techniques for diseased aortic valves have received increasing attention. This study reports the short-term outcome of aortic valve repair (AVr) for three pathologic categories: rheumatic heart disease, aortic regurgitations (ARs) from subarterial ventricular septal defect (VSD), and infective endocarditis in order achieve the valve competency.

From January 2017 to March 2019, 30 patients underwent AVr with significant AR in the National Heart Institute (NHI) and Banha university. All patients underwent echocardiography before and after the procedure; 30 patients underwent AVr with significant AR, nine patients (30%) with juxta-arterial VSD, two patients (6.66%) with infective endocarditis (IE), and 19 patients (63.33%) with rheumatic aortic valve disease. For intraoperative transesophageal echocardiography and direct examination for better clarification of the anatomy and guidance of repair after cardiopulmonary bypass (CPB), annular repair, leaflet repair by shaving, plication, triangular resection, augmentation with the pericardium, and VSD closure were done.

Only three patients developed aortic incompetence grade II, no in-hospital mortality; however, we had 3 months later mortality for one patient with IE, only one patient with rheumatic heart disease progressed from grade II to grade IV aortic incompetence (AI) and aortic valve replacement was done so AVr was successfully done for the subaortic VSD, rheumatic, and IE patients instead of replacement of the valve.

In favor of AVr, good patient selection, amenable techniques for the suitable pathology will give a good target hence the aim of the work.