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Aortic root aneurysms: remodeling or composite replacement?

T E David1

  • 1Division of Cardiovascular Surgery, Toronto Hospital, University of Toronto, Ontario, Canada.

The Annals of Thoracic Surgery
|December 5, 1997
PubMed
Summary
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Aortic valve-sparing operations offer excellent midterm results for patients with ascending aortic aneurysms and normal valve leaflets, demonstrating high survival and low rates of reoperation or insufficiency.

Area of Science:

  • Cardiovascular Surgery
  • Thoracic Surgery
  • Aortic Aneurysm Treatment

Background:

  • Ascending aortic aneurysms often lead to aortic insufficiency due to aortic root dilatation.
  • Composite valve and ascending aorta replacement is standard, but valve-sparing surgery is an option for select patients.
  • Patients with normal aortic valve leaflets are candidates for aortic valve-sparing procedures.

Purpose of the Study:

  • To evaluate the midterm outcomes of aortic valve-sparing operations.
  • To assess the feasibility and efficacy of valve-sparing techniques in patients with aortic root aneurysms.

Main Methods:

  • A total of 101 patients underwent aortic valve-sparing operations between 1988 and 1996.
  • Procedures included aortic root remodeling (73 patients) or valve reimplantation (28 patients).

Related Experiment Videos

  • Follow-up averaged 31 months, with annual Doppler echocardiography.

    • Main Results:

    • Two operative deaths occurred; one patient required aortic valve replacement postoperatively.
    • Actuarial survival at 6 years was 87% ± 5%.
    • Freedom from aortic valve replacement at 6 years was 97% ± 2%, with no thromboembolic or infective complications.

    Conclusions:

    • Aortic valve-sparing operations yield excellent midterm results for aortic root aneurysms.
    • These procedures are justified in patients with normal or near-normal aortic valve leaflets.
    • The technique demonstrates favorable long-term outcomes and patient safety.