[Results of valve-sparing correction of aortic valve insufficiency]

The risk of valve-related complications and the necessity of anticoagulation in patients with prosthetic valves, has led to new operative techniques in the correction of severe aortic insufficiency. In the last 2 years, 35 patients (mean age 41.3 years, range 10-80 years) with aortic insufficiency underwent reconstructive valves surgery. Eighteen patients had a commissuroplasty with or without triangular resection. In 5 patients with perforation, the valves could be reconstructed with a pericardial patch. In 12 patients with insufficiency due to aortic aneurysm, the valves were resuspended within the aortic prosthesis. In 2 patients the aortic valves were replaced intraoperatively because of unsatisfactory results. The perioperative mortality was 5.7%. The echocardiographic degree of aortic insufficiency decreased from 3.3 +/- 0.5 preoperatively to 0.45 +/- 0.53 postoperatively. Two patients were reoperated within the first week. Five of 23 patients at 1-year follow-up have mild to moderate aortic insufficiency. Mean ventricular dimensions and function at discharge and after 1-year follow-up are normal. With the new operative techniques described recently, valve-sparing corrections of aortic insufficiency are possible in an increasing number of patients, and autologous valve tissue can be saved. With more refinement of surgical technique, early postoperative results will further improve.