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Interact Cardiovasc Thorac Surg. 2005 Apr;4(2):137-9. doi: 10.1510/icvts.2004.095422. Epub 2005 Feb 16.

Aortic valve-sparing operations in patients with aneurysms of the aortic root or ascending aorta: preliminary results.

Interactive cardiovascular and thoracic surgery

Fabrizio Settepani, Diego Ornaghi, Alessandro Barbone, Enrico Citterio, Alessandro Eusebio, Eric Manasse, Giuseppe Silvaggio, Roberto Gallotti

Affiliations

  1. Department of Cardiac Surgery, Istituto Clinico Humanitas, Via Manzoni 56, cap: 20089, Rozzano (MI), Italy. [email protected]

PMID: 17670375 DOI: 10.1510/icvts.2004.095422

Abstract

OBJECTIVE: Aortic valve-sparing operations were developed to preserve the native aortic valve in patients with aneurysms of the aortic root or ascending aorta and normal aortic valve leaflets. This paper describes our initial experience with valve-sparing operations and early clinical and echocardiographic results obtained.

METHODS: From October 2002 to March 2004, 32 consecutive patients underwent aortic valve-sparing operations at the Istituto Clinico Humanitas, Rozzano, Italy. Preoperative transesophageal echocardiography showed moderate or severe aortic incompetence (AI) in 15 patients (47%). Twenty-nine patients underwent reimplantation of the aortic valve and 3 patients remodeling of one sinus. In 2 cases prolapsing cusp repair was carried out.

RESULTS: There were no intraoperative deaths. At discharge, two-dimensional echocardiogram showed no or trivial aortic incompetence (AI) in 17 (52%) patients and mild AI in 13 (42%); 2 (6%) patients had severe AI requiring reoperation, respectively 4 and 6 weeks later.

CONCLUSIONS: The valve-sparing procedures showed good preliminary results, thus encouraging further use of this type of repair. However, further larger studies and long-term results are needed in order to define the durability of these techniques.

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