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Repair of trileaflet aortic valve prolapse: mid-term outcome in patients with normal aortic root morphology

^a Department of Thoracic and Cardiovascular Surgery, Saint Luc Hospital, Université Catholique de Louvain, avenue Hippocrate 10, 1200 Brussels, Belgium
^b Department of Cardiology, Saint Luc Hospital, Université Catholique de Louvain, Brussels, Belgium
^c Department of Thoracic and Cardiovascular Surgery, Saint Luc Hospital, Université Catholique de Louvain, Brussels, Belgium

*Corresponding author. Tel.: +32-276-46113; fax: +32-276-48960.

E-mail address: bruno_chiappini{at}hotmail.com (B. Chiappini).

We described our mid-term results in repairing prolapsing aortic cusps in 21 patients with aortic regurgitation and normal aortic root morphology. Aortic regurgitation was moderate–severe in five patients and severe in 16 patients. Prolapse involved the left cusp in four patients (19%), the right cusp in 10 patients (47%) and the non-coronary cusp in 7 (33%) patients. Correction of the prolapsing cusp was achieved by either free edge plication, triangular resection or resuspension with polytetrafluoroethylene sutures, frequently associated to a subcommissural annuloplasty. There was no hospital death. At discharge transthoracic echocardiography, 18 patients (85%) showed no residual aortic regurgitation and three patients (14%) had trivial aortic regurgitation with a central jet. Mean clinical follow-up was 27.2±17.1 months (range: 10–72 months). Overall survival was 90.5%. At follow-up transthoracic echocardiography, fourteen patients (73%) were free from aortic regurgitation and five patients (26%) had mild aortic regurgitation without clinical signs of congestive heart failure. Correction of valve prolapse appears a reasonable extension of the original techniques of valve-preserving surgery.

Key Words: Aortic valve repair; Valve disease