Display Settings:

Format

Send to:

Choose Destination
See comment in PubMed Commons below
J Card Surg. 2007 Nov-Dec;22(6):473-9.

Aortic valve repair and root preservation by remodeling, reimplantation, and tailoring: technical aspects and early outcome.

Author information

  • 1Center for Aortic Surgery, Marfan Syndrome and Connective Tissue Disorders Clinic, Department of Thoracic and Cardiovascular Surgery, The Cleveland Clinic Foundation Cleveland, Ohio 44195, USA. svenssl@ccf.org

Abstract

OBJECTIVES:

Evaluate aortic root preserving/sparing procedures for various pathologies associated with ascending aortic aneurysms, including aortic valve regurgitation.

METHODS:

From the end of 1990 through end of 2004, 388 patients had aortic root preserving procedures (reimplantation 72, remodeling 77, tailoring 239) +/- leaflet repair. Preoperatively, in-house grade aortic regurgitation was 1(+) in 58, 2(+) in 110, 3(+) in 101, and 4(+) in 66. Concurrent leaflet repairs were done in 197 (50.8%, Cabrol/Trusler commissure stitch 158, leaflet plication 36, supracommissure stitch 42, leaflet resection and repair 16, perforation repair 18, and debridement 11). Additional procedures included arch repair in 227 (58%), coronary bypass in 83 (21.4%), elephant trunk in 33 (8.5%), and minimally invasive approach in 30 (7.7%). Pathologies included dissection in 140 (36%; 86 acute), Marfan syndrome in 39 (10%), bicuspid valve in 78 (20%), and degenerative aneurysm in 142 (36.6%). The CLASS (Commissure, Leaflet, Annulus, Sinuses, Sinotubular) evaluation schema is described that is used for selecting either reimplantation, remodeling, or tailoring of the aortic root according to underlying pathology.

RESULTS:

Hospital survival was 97.4% (378/388) and stroke occurred in 4.6% (18/388, four permanent, [1%]). On postoperative echocardiography, patients had either no (0) or 1(+) regurgitation (1(+)= 98);13 (3.4%) had 2(+). Three patients (1%) required reoperation for aortic valve failure before discharge (two tailoring, one remodeling).

CONCLUSIONS:

Excellent early results can be achieved by aortic root preserving procedures and concurrent aortic valve leaflet repairs when appropriately selected for a diverse class of pathologies.

PMID:
18039206
[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Blackwell Publishing
    Loading ...
    Write to the Help Desk