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Ann Thorac Surg 2007;83:S732-S735
© 2007 The Society of Thoracic Surgeons

Supplement

Aortic Valve Preservation in Patients With Aortic Root Aneurysm: Results of the Reimplantation Technique

Tirone E. David, MD*, Christopher M. Feindel, MD, Gary D. Webb, MD, Jack M. Colman, MD, Susan Armstrong, MSc, Manjula Maganti, MSc

Divisions of Cardiovascular Surgery and Cardiology of Toronto General Hospital and University of Toronto, Toronto, Ontario, Canada

Accepted for publication October 17, 2006.

* Address correspondence to Dr David, 200 Elizabeth St. 4N-457, Toronto, Ontario M5G 2C4, Canada. (Email: tirone.david{at}uhn.on.ca).

Presented at Aortic Surgery Symposium X, New York, NY, April 27–28, 2006.

BACKGROUND: A study was conducted to determine the long-term results of aortic valve reimplantation to treat aortic root aneurysm.

METHODS: Prospective follow-up with clinical assessments and echocardiography was done of 167 consecutive patients who had reimplantation of the aortic valve as treatment of aortic root aneurysm. Their mean age was 45 ± 15 years, 78% were men, 38% had Marfan syndrome, 14% had aortic dissection, and 7% had bicuspid aortic valve. The aortic valve was reimplanted into a straight Dacron (Dupont, Wilmington, DE) tube in 89 patients and in a Dacron tube with creation of neoaortic sinuses in 78. Aortic cusp repair was performed in 66 patients, and the free margin was reinforced with a fine Gore-Tex suture (W.L. Gore & Assoc, Flagstaff, AZ) in 36. The mean follow-up was 5.1 ± 3.8 years and was 100% complete.

RESULTS: There were two operative and six late deaths. Survival at 10 years was 92% ± 3%. Moderate aortic insufficiency developed in 3 patients, and severe developed in 2. Freedom from moderate or severe aortic insufficiency was 94% ± 4% at 10 years. Two patients required aortic valve replacement. Freedom from aortic valve replacement was 95% ± 4% at 10 years. At the latest follow-up, 90% of the patients were in New York Heart Association functional class I and 10% were in class II.

CONCLUSIONS: Reimplantation of the aortic valve to treat patients with aortic root aneurysm is associated with excellent long-term survival and low rates of valve-related complications. Reimplantation of the aortic valve is a durable type of aortic valve repair.




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Ann. Thorac. Surg., September 1, 2007; 84(3): 1006 - 1006.
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