[Aortic valvuloplasty in acquired valvular disease]

Area of Science:

• Cardiovascular Surgery
• Cardiac Valve Repair
• Aortic Root Reconstruction

Context:

• Understanding the complex biomechanics and physiology of the aortic root and aortic valve cusps is crucial for developing effective surgical interventions.
• Degenerative changes, such as coarse calcinosis, represent a significant challenge in aortic valve surgery, often necessitating valve replacement.

Purpose:

• To present a novel set of surgical manipulations aimed at preserving the patient's native aortic valve.
• To establish the indications and contraindications for aortic valve-sparing procedures.
• To evaluate the efficacy and safety of these valvuloplasty techniques.

Summary:

• The study details a surgical approach for aortic valve repair, preserving the native valve in most cases. Coarse calcinosis of the aortic root and valve cusps is identified as the sole absolute contraindication.
• The initial 100 cases showed an 8.0% hospital mortality rate. Intraoperative hemodynamic assessment confirmed successful correction of the abnormality in nearly all patients.
• Follow-up data up to 5.5 years revealed recurrent aortic insufficiency in four patients, necessitating reoperation. The authors advocate for the broader clinical adoption of these aortic valve plastic operations.

Impact:

• This valvuloplasty technique offers a viable alternative to aortic valve replacement, potentially improving long-term patient outcomes and quality of life.
• The findings support the feasibility of valve-sparing surgery, encouraging further research and refinement of techniques for aortic valve repair.
• Successful application of these plastic operations can reduce the need for prosthetic valves, mitigating associated complications and costs.