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Aortic valve-sparing operations in patients with aneurysms of the aortic root or ascending aorta: preliminary results

Department of Cardiac Surgery, Istituto Clinico Humanitas, Via Manzoni 56, cap: 20089, Rozzano (MI), Italy

*Corresponding author. Tel.: +39-02-82244602; fax: +39-02-82244691 .

E-mail address: sieben2000{at}yahoo.com (F. Settepani).

Objective: Aortic valve-sparing operations were developed to preserve the native aortic valve in patients with aneurysms of the aortic root or ascending aorta and normal aortic valve leaflets. This paper describes our initial experience with valve-sparing operations and early clinical and echocardiographic results obtained. Methods: From October 2002 to March 2004, 32 consecutive patients underwent aortic valve-sparing operations at the Istituto Clinico Humanitas, Rozzano, Italy. Preoperative transesophageal echocardiography showed moderate or severe aortic incompetence (AI) in 15 patients (47%). Twenty-nine patients underwent reimplantation of the aortic valve and 3 patients remodeling of one sinus. In 2 cases prolapsing cusp repair was carried out. Results: There were no intraoperative deaths. At discharge, two-dimensional echocardiogram showed no or trivial aortic incompetence (AI) in 17 (52%) patients and mild AI in 13 (42%); 2 (6%) patients had severe AI requiring reoperation, respectively 4 and 6 weeks later. Conclusions: The valve-sparing procedures showed good preliminary results, thus encouraging further use of this type of repair. However, further larger studies and long-term results are needed in order to define the durability of these techniques.

Key Words: Aortic valve leaflets; Valve-sparing operations; Aortic root