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Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
Published on: May 21, 2017
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Long-term outcomes following valve-sparing root replacement with concomitant mitral repair
Maral Ouzounian1, Myriam Lafreniere-Roula1, Malak Elbatarny1
1Division of Cardiovascular Surgery, Peter Munk Cardiac Centre, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada.
The Journal of Thoracic and Cardiovascular Surgery
|March 8, 2024
Summary
Valve-sparing root replacement with mitral valve repair shows excellent long-term survival and low complication rates. Continued surveillance is recommended for patients undergoing these aortic and mitral valve procedures.
Area of Science:
- Cardiovascular Surgery
- Cardiac Surgery Outcomes
- Aortic Root Surgery
Background:
- Valve-sparing root replacement (VSRR) is an alternative to composite valve replacement for aortic root aneurysm.
- Concomitant mitral valve repair is often performed with VSRR.
- Long-term outcomes of combined VSRR and mitral valve repair are not well-established.
Purpose of the Study:
- To evaluate the late clinical outcomes of valve-sparing root replacement and concurrent mitral valve repair.
- To assess survival, reoperation rates, and valve function after combined aortic and mitral valve surgery.
Main Methods:
- Prospective follow-up of 54 patients undergoing VSRR (reimplantation or remodeling) and mitral valve repair from 1992 to 2020.
- Median follow-up duration of 9 years (IQR, 3-14 years).
- Analysis of overall survival, reoperation rates, and valve function via echocardiography.
Main Results:
- No perioperative death or stroke observed.
- 15-year overall survival was 96.0%, comparable to the general population.
- 10-year cumulative reoperation rates: aortic valve 11.4%, mitral valve 4.2%, either or both valves 11.4%.
- 15-year estimated moderate/severe aortic insufficiency: 18.5%; no moderate/severe mitral regurgitation.
Conclusions:
- Combined valve-sparing root replacement and mitral valve repair yields excellent clinical outcomes.
- Low risk of death and valve-related complications observed in this cohort.
- Long-term surveillance of valve function is crucial after these procedures.
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