Aortic valve-sparing operations in patients with ascending aortic aneurysms

Area of Science:

• Cardiovascular Surgery
• Cardiac Valve Repair
• Aortic Root Surgery

Background:

• Composite replacement of the aortic valve and ascending aorta was standard for aortic insufficiency and root aneurysms.
• Nearly half of patients undergoing aortic root aneurysm surgery have normal or near-normal aortic valve leaflets.
• Advances in transesophageal echocardiography and understanding of aortic root anatomy enable valve preservation.

Purpose of the Study:

• To evaluate the feasibility and outcomes of aortic valve-sparing operations.
• To compare valve-sparing procedures with traditional composite replacement.
• To assess the long-term stability of repaired aortic valves.

Main Methods:

• Performed aortic valve-sparing operations on 97 patients since 1988.
• Utilized transesophageal multiplane echocardiography to assess aortic valve leaflet quality.
• Employed various valve-sparing techniques based on the specific pathology of aortic insufficiency and aortic root.

Main Results:

• Excellent clinical results were observed in patients undergoing aortic valve-sparing surgery.
• Aortic valve repair remained stable for up to 8 years in the studied cohort.
• The procedure demonstrated significant potential for preserving native valve function.

Conclusions:

• Aortic valve-sparing operations are a safe and effective alternative to composite replacement for select patients.
• The long-term stability of valve repair supports the continued use of these procedures.
• Further long-term data will continue to refine patient selection and surgical techniques.