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

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Supplement

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

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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