Objective: To determine the feasibility of original aortic valve reconstruction, 404 consecutive cases were reviewed. The early results are reported here.
Methods: Aortic valve reconstruction was performed for 404 patients from April 2007 through September 2011. The results for all 404 patients were reviewed retrospectively. There were 289 patients with aortic stenosis and 115 patients with aortic regurgitation. One hundred two patients had bicuspid aortic valves, 13 patients had unicuspid valves, and 2 patients had quadricuspid valves. There were 201 males and 203 females. Mean age was 69.0 ± 12.9 years. Preoperative echocardiography revealed an average peak pressure gradient of 79.6 ± 32.5 mm Hg with aortic stenosis. Surgical annular diameter was 20.3 ± 3.2 mm. The surgical procedure is based on the independent tricuspid replacement by autologous pericardium. First, the distance between the commissure is measured with an original sizing apparatus, then the pericardial cusp is trimmed using an original template, and it is sutured to the annulus.
Results: There were no conversions to prosthetic valve replacement. There were 7 in-hospital mortalities resulting from a noncardiac cause. Postoperative echocardiography revealed an average peak pressure gradient of 19.8 ± 10.2 mm Hg 1 week after surgery and 13.8 ± 3.7 mm Hg 3.5 years after surgery. Two patients needed reoperation because of infective endocarditis. The other 402 patients showed less than mild aortic regurgitation. No thromboembolic events were recorded. The mean follow-up period was 23.7 ± 13.1 months. Freedom from reoperation was 96.2% at 53 months of follow-up.
Conclusions: Original aortic valve reconstruction was feasible in patients with various aortic valve diseases. Long-term data will be disclosed in the future.
Keywords: 35; AR; AS; IE; PVE; aortic regurgitation; aortic stenosis; infective endocarditis; prosthetic valve endocarditis.
Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.