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Remodeling of the aortic valve anulus
1Department of Cardiothoracic Surgery, National Heart Hospital, London, England.
The Journal of Thoracic and Cardiovascular Surgery
|March 1, 1993
Summary
Aortic valve regurgitation due to aortic wall disease can be treated by remodeling the aortic anulus. This surgical technique restores normal geometry, accommodating leaflet surface area increases from root dilatation.
Area of Science:
- Cardiovascular Surgery
- Cardiac Anatomy
- Aortic Valve Disease
Background:
- Isolated aortic valve regurgitation often stems from primary aortic wall disease.
- Aortic root dilatation can lead to increased leaflet surface area, complicating repair.
- Annuloaortic ectasia presents specific challenges for aortic valve repair.
Purpose of the Study:
- To describe the experience with aortic anulus remodeling for isolated aortic valve regurgitation.
- To evaluate the efficacy of this remodeling technique in patients with annuloaortic ectasia.
- To detail the surgical steps involved in aortic anulus remodeling.
Main Methods:
- Surgical excision of diseased aortic wall to within 2-3 mm of leaflet attachments.
- Detachment and reimplantation of coronary ostia.
- Reshaping the aortic anulus using a Dacron graft.
Main Results:
- The study involved 10 patients with annuloaortic ectasia undergoing the remodeling procedure.
- The procedure accommodates increased leaflet surface area due to root dilatation.
- The remodeling technique aims to restore normal aortic anulus geometry.
Conclusions:
- Aortic anulus remodeling is a viable surgical option for isolated aortic valve regurgitation caused by aortic wall disease.
- The technique effectively addresses geometric abnormalities and leaflet surface area changes.
- Experience gained from 1982-1990 at leading cardiac hospitals informs this surgical approach.