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Ann Thorac Surg 2005;80:839-843
© 2005 The Society of Thoracic Surgeons
Department of Cardiovascular Surgery, Cardiovascular Center Bad Neustadt, Bad Neustadt, Germany
Accepted for publication December 28, 2004.
* Address reprint requests to Dr Urbanski, Herz- und Gefaess-Klinik, Salzburger Leite 1, 97616 Bad Neustadt, Germany (Email: p.urbanski{at}herzchirurgie.de).
BACKGROUND: In the valve-sparing aortic root repair technique presented, each pathologic sinus is replaced with a teardrop-shaped patch. In this study, the clinical and echocardiographic results after the first 20 procedures are evaluated.
METHODS: Between September 2000 and May 2004, 20 patients underwent aortic root repair using a patch technique. Eight patients had an acute type A aortic dissection and 12 patients had an aneurysm of the ascending aorta. In 12 cases, the aortic root was reconstructed with three patches, in 1 case with two patches, and in 7 cases with one patch.
RESULTS: The postoperative echocardiography at discharge showed no aortic regurgitation in 15 cases and trivial regurgitation in 5 cases. Three patients with aortic dissection as an initial pathologic diagnosis died during a median follow-up period of 14.5 months (range, 0.5 to 32 months). At the time of follow-up, the echocardiographic findings in all 17 survivors remained unchanged from the early postoperative examinations. Median peak and mean transvalvular gradients were 8 mm Hg (range, 3.2 to 14 mm Hg) and 4 mm Hg (range, 1.7 to 6 mm Hg), respectively.
CONCLUSIONS: The technique presented allows an individualized reconstruction of the sinuses of Valsalva, a simplified sizing of the vascular graft, and the creation of a new sinotubular junction resulting in good hemodynamic conditions. The technique is especially advantageous in patients in whom replacement of all sinuses is not necessary.
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M. J. Reardon and J.-C. Walkes Invited commentary Ann. Thorac. Surg., September 1, 2005; 80(3): 843 - 844. [Full Text] [PDF]
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