Aortic Valve-Sparing Operation with Reimplantation Technique

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Abstract

Introduction: The aortic valve-sparing operation offers the unique possibility of preserving the native valve in patients who need surgical treatment for aortic root disease.
Objective: The aim of this study was to assess the long term outcome of the aortic valve-sparing operation with reimplantation technique at the Hospital Universitario Fundación Favaloro.
Methods: A total of 66 patients underwent aortic valve-sparing operation from June 1998 to December 2011. Fifty three patients operated on with the aortic valve reimplantation technique were included in the study and 13 patients operated with the remodeling technique were excluded. Clinical and echocardiographic follow-up was performed. Aortic insufficiency was graded as 0: absent; 1+: mild; 2+: moderate; 3+: moderate-severe, and 4+: severe. Survival and freedom from aortic insufficiency >2+ and reoperation were analyzed using the Kaplan Meier method.
Results: Mean age was 45±17 years, 79% of patients were men and 36% had Marfan syndrome. In-hospital and late mortality
was 3.8%. Survival at 8 years was 91% (95% CI: 78-97%). Freedom from aortic insufficiency > 2+ and reoperation at 8 years was 84% (95% CI: 66-92%) and 90% (95% CI: 74-96%), respectively. Preoperative aortic insufficiency >2+ was not associated with aortic insufficiency >2+ (RR 1.45; p=0.16) or reoperation (RR 1.96; p=0.4) during follow-up.
Conclusions: In our experience, the aortic valve-sparing operation with reimplantation technique in patients with aortic root disease shows comparable results to other published international series. This surgical technique is a valid option for eligible patients duly informed about the different surgical techniques, and should be performed in experienced centers.