Repair of asymptomatic aortic valve disease during other cardiac surgery.
Repair of asymptomatic aortic valve disease was performed in 12 patients (9 female, 3 male, mean age 57.5 years) undergoing other cardiac surgery. Stenosis was the predominant aortic valve lesion in 7 (group A) with a mean gradient of 33.4 mmHg and regurgitation of mean grade 1.4 was predominant in 5 (group B). Cusp debridement +/- commissurotomy was performed in 9; commissural resuspension in 6 and repair of cusp perforation in 2. Perioperative transoesophageal echocardiography was used to assess the adequacy of repair in 4 patients. Prospective precordial echocardiographic follow-up is complete (mean 4.3 months). In group A there has been a significant reduction is peak aortic pressure gradient (33.4 vs 22.1 mmHg, p less than 0.05) and in cusp thickness (2.25 to 1.64 mm, p less than 0.05). In group B the degree of incompetence has improved in 3 of the 5 patients. Three patients have worsened valve disease following repair; in all these there was mixed valve disease of rheumatic origin. Aortic valve repair of asymptomatic disease during other cardiac surgery is a feasible technique which does not accelerate the disease process in the short term. Long-term follow-up is in progress to assess the prognosis of this preventive intervention.
Waller
D A
DA
Department of Cardiothoracic Surgery, Killingbeck Hospital, Leeds, UK.
Essop
A R
AR
Scott
P J
PJ
Nair
R U
RU
D000328:Adult; D000368:Aged; D001022:Aortic Valve Insufficiency / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D006348:Cardiac Surgical Procedures / Q000379:methods* / Q000401:mortality / Q000592:standards*; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000401:mortality; D011446:Prospective Studies; D016896:Treatment Outcome