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The Annals of Thoracic Surgery, Vol 52, 447-453, Copyright © 1991 by The Society of Thoracic Surgeons
C Duran, N Kumar, B Gometza and Z al Halees
To elucidate the value of conservative operation for aortic regurgitation,
all consecutive patients operated on between July 1988 and July 1990 were
reviewed. Of 251 patients with aortic regurgitation, 107 (42.6%) had
nonprosthetic operation. The mean age was 23 years, and 90 patients (84.1%)
were rheumatic. Two techniques were used: repair (annular and leaflet
plasties, 69 cases) and cusp extension with glutaraldehyde-treated
pericardium (25 bovine, 13 autologous). There were two hospital deaths
(1.8%), both in the repair group, and no late deaths or embolic events.
Only 5 patients (4.7%) were anticoagulated. In the repair group there were
12 reoperations, four (5.9%) due to aortic and eight to mitral dysfunction.
In the cusp extension group there were two reoperations due to mitral
dysfunction. Echocardiographic follow-up showed better results with cusp
extension. In conclusion, conservative operation for aortic regurgitation
is possible in a high percentage of young rheumatic patients and does not
require anticoagulation. Cusp extension is more reliable than repair in
terms of early results, although its long-term durability is not yet known.
ARTICLES
Indications and limitations of aortic valve reconstruction
Department of Cardiovascular Diseases, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
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