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Ann Thorac Surg 1988;45:181-185
© 1988 The Society of Thoracic Surgeons

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Articles

The Surgical Treatment of Aortic Regurgitation Secondary to Aortitis

From the Second Department of Surgery, Kurume University Hospital, Kurume, Fukuoka, Japan

Accepted for publication September 10, 1987.

^* Address reprint requests to Dr. Isomura, The Second Department of Surgery, Kurume University Hospital, 67 Asahi-Machi, Kurume, Fukuoka, Japan 830

We describe the operative and perioperative management of 11 patients with aortic regurgitation due to aortitis. All patients required aortic valve replacement because of severely uncoapted cusps secondary to dilatation of the ascending aorta. The right coronary ostium was narrowed in 5 patients and consequently necessitated a smaller coronary tip for the administration of cardioplegic solution. To implant the prosthetic valve, pledgeted 2-0 Tevdek sutures were placed through the aortic valve annulus either from the ventricular side or from outside the aortic wall. Steroids were administered to 4 patients preoperatively and 8 patients postoperatively. Postoperative dehiscence of the prosthesis was seen in 1 of the 3 patients not given any steroids. We conclude that it is important to arrest the inflammatory reaction before operation and if the aortic valve must be replaced, to reinforce the implanted prosthesis with pledgeted sutures. Also, we suggest the possible importance of steroid therapy.

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