Related Experiment Videos
Lunular hypertrophy and aortic valve disease
N Shapira1, J Fernandez, K J Hirshfeld
1Division of Cardiovascular Surgery, Medical Center of Delaware, Wilmington.
The Annals of Thoracic Surgery
|February 1, 1994
Summary
A newly identified cause of aortic valve dysfunction, lunular hypertrophy, was successfully treated with surgical repair in 50 adults. Most patients experienced excellent long-term outcomes, demonstrating the efficacy of this novel aortic valve repair technique.
Area of Science:
- Cardiology
- Cardiac Surgery
- Valvular Heart Disease
Background:
- Abnormal cusp hypertrophy and stiffening (lunular hypertrophy) is a previously unrecognized cause of aortic valve dysfunction.
- This condition affects the line of apposition between aortic valve cusps.
Purpose of the Study:
- To investigate the clinical entity of lunular hypertrophy as a cause of aortic valve dysfunction.
- To evaluate the efficacy of surgical repair for aortic valve dysfunction caused by lunular hypertrophy.
Main Methods:
- Surgical shaving of hypertrophic protuberances was performed in 50 adult patients.
- Aortic valve repair involved shaving alone in 26 patients and additional procedures in 24.
- Concomitant cardiac procedures included mitral valve repair/replacement, tricuspid valve repair, coronary artery bypass grafting, and aortic aneurysm repair.
Main Results:
- Operative mortality was 10% (5 patients), unrelated to aortic valve repair.
- At a mean follow-up of 56 months, 93% of patients had trivial or no recurrent aortic valve dysfunction.
- The 6-year actuarial freedom from aortic valve-related problems was 92%.
Conclusions:
- Lunular hypertrophy is a significant, treatable cause of aortic valve dysfunction.
- Surgical repair, primarily involving shaving of hypertrophic protuberances, yields excellent long-term results.
- This approach offers a high degree of freedom from aortic valve-related complications.