Cor Vasa 2013, 55(6):e479-e486 | DOI: 10.1016/j.crvasa.2013.09.002

Aortic valve repair in patients with aortic regurgitation: Experience with the first 100 cases

Tomáš Holubec^a,b,*, Pavel Žáček^b, Martin Tuna^b, Jan Dominik^b, Jan Harrer^b, Petr Telekeš^c, Pavel Nedbal^c, Jan Vojáček^b

^a Department of Cardiovascular Surgery, University Hospital Zurich, Curych, Švýcarsko

^b Kardiochirurgická klinika, Univerzita Karlova v Praze, Lékařská fakulta a Fakultní nemocnice Hradec Králové, Hradec Králové, Česká republika

^c Klinika kardiologie, Kardiocentrum, Krajská nemocnice Liberec, a. s., Liberec, Česká republika

Introduction: The aim of this study was to analyze short- and mid-term results of aortic valve repair.

Material and methods: One hundred consecutive patients (24 females; mean age 50.3 years, range 23-77 years) with aortic regurgitation underwent aortic valve repair between November 2007 and October 2012. Sixty patients had bicuspid aortic valve, and 82 patients demonstrated aortic regurgitation greater than mild (> grade 2). The ascending aorta/aortic root was replaced in 67 patients. Aortic cusp repair was necessary in 74 patients and additional aortic annulus stabilization was required in 48 cases. Follow-up ranged from 1 to 59 months (cumulative of 220 patient-years, median 25 months) and was complete in 100%.

Results: There was no 30-day mortality and 2 patients died in the follow-up. The overall 4-year survival was 98% and freedom from cardiac death was 99% at 4 years. During the follow-up 8 patients underwent aortic valve-related reoperation due to progression of aortic regurgitation and another 6 patients showed aortic regurgitation. In both aspects there was no statistically significant difference between patients without and with aortic root replacement (p = .402 and p = .650). There were no significant bleeding or thromboembolic events during the follow-up.

Conclusions: Short- and mid-term data analysis revealed an excellent survival and acceptable results of aortic repair, comparable with other larger published studies. We think, therefore, aortic valve repair should be a part of contemporary cardio-surgical armamentarium, especially in younger patients with an appropriate indication.

Keywords: Aortic regurgitation; Aortic valve repair; Aortic valve-sparing operations

Received: June 3, 2013; Revised: August 27, 2013; Accepted: September 11, 2013; Published: December 1, 2013  Show citation