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Ann Thorac Surg 2005;79:1921-1925
© 2005 The Society of Thoracic Surgeons

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Original article: Cardiovascular

Aortic Valve Repair for Rheumatic Aortic Valve Disease

Cardiothoracic Centre, All India Institute of Medical Sciences, New Delhi, India

Accepted for publication November 22, 2004.

^_* Address reprint requests to Dr Kumar, Department of Cardiothoracic and Vascular Surgery, Cardiothoracic Centre, All India Institute of Medical Sciences, Ansari Nagar, New Delhi—110 029, India (E-mail: asampath_kumar{at}hotmail.com).

BACKGROUND: The aim of this study is to assess the long-term results of aortic valve repair in patients with rheumatic aortic valve disease.

METHODS: From April 1991 through December 2003, 61 patients with rheumatic aortic valve disease underwent aortic valve repair. Mean age was 23.7 ± 9.3 years (range, 6 to 53 years). Thirty-nine (63.9%) patients were in New York Heart Association functional class III. Reparative procedures included cuspal thinning (n = 59), commissurotomy (n = 45), subcommissural annuloplasty (n = 24), commissural plication (n = 12), perforation closure using pericardium (n = 2), and decalcification of cusps (n = 2). Associated procedures included mitral valve repair (n = 36) and tricuspid valve repair with mitral valve repair (n = 5).

RESULTS: Early mortality was 4.9% (3 patients). Mean follow-up was 93.8 ± 46.4 months (range, 6 to 160 months, median, 103 months). Forty-six survivors (65%) had no or trivial or mild aortic regurgitation. Four patients required reoperation for valve dysfunction. There were no late deaths. Actuarial and reoperation-free survival, at 160 months, was 95.2% ± 2.8% and 85.4% ± 6.7%, respectively. Freedom from significant aortic stenosis or regurgitation was 52.4% ± 16.9%.

CONCLUSIONS: Aortic valve repair in patients with rheumatic aortic valve disease is feasible and yields gratifying long-term results.

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