Non-prosthetic aortic valve surgery.
Due to significant improvements in myocardial protection, old techniques are being re-explored today in search for the ideal solution for aortic valve disease. We reviewed all patients who underwent non-prosthetic aortic valve surgery between July 1988 and March 1994. There were 361 such patients with a mean age of 22.18 years, mean preoperative functional class of 2.65 and sinus rhythm in 89.75%. The etiology was rheumatic in 65.65% and congenital in 26.37%. Simultaneous mitral surgery was performed in 44% of the cases with repair in 76.73%. A homograft was used in 11 patients with one hospital death, no late deaths and no reoperations. A pulmonary autograft was used in 58 with no hospital deaths, one (1.72%) late death (car accident) and three (5.17%) reoperations due to progressive regurgitation in two. Reconstruction with pericardium was performed in 76 patients with no hospital deaths, three (3.95%) late deaths (one car accident) and four (5.26%) reoperations due to endocarditis in two and valve failure in two. Repair was done in 216 patients with eight (3.7%) hospital and nine (4.32%) late deaths, and 25 (12%) reoperations. Excluding those patients with mitral surgery, there were no thromboembolic events with only two patients (1.02%) anticoagulated. The total actuarial survival was 91.76 +/- 2.40% at 66 months. It is concluded that non-prosthetic aortic valve surgery offers a very attractive alternative for our patient population.
Department of Cardiovascular Diseases, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
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Duran
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Gometza
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al-Halees
D000328:Adult; D000368:Aged; D001021:Aortic Valve / Q000503:physiopathology / Q000601:surgery*; D006348:Cardiac Surgical Procedures / Q000145:classification / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D012086:Reoperation; D015996:Survival Rate