[Reimplantation of aortic valve; preliminary results in 13 patients].
OBJECTIVE
To evaluate our initial experience with the reimplantation technique of the aortic valve.


METHODS
Retrospective.


METHODS
From January 1st 1998 to January 31st 2000, 13 patients were operated on by the technique as described by David. Mean age was 52.2 years (SD: 11). Median preoperative New York Heart Association (NYHA) functional class was 2/4 and median preoperative degree of aortic regurgitation was 3/4. Surgical indications were initially limited to aneurysmal disease of the aortic root (n = 6) and ascending aorta (n = 4), all complicated by aortic regurgitation. Later on, we also applied the technique in type A aortic dissection (n = 3). The repair was evaluated peroperatively by transoesophageal and postoperatively, by transthoracic echocardiography. The patients were followed postoperatively in the outpatient department.


RESULTS
No technical problems arose that necessitated change or adjustment of the technique. Mean cardiac arrest time was 184 min (SD: 40) and cardiopulmonary bypass time 254 min (SD: 74). The primary aetiology on histopathological examination was medial necrosis in 5 patients and degenerative disease in the others. There was no early nor late mortality and none of the patients was reoperated upon the aortic root. Follow-up was complete at a mean of 12.3 months (SD: 8). Median aortic regurgitation at follow-up was 0.5 (p = 0.0001 versus preoperative) and median NYHA functional class at follow-up was 1 (p = 0.02 versus preoperative).


CONCLUSIONS
David's aortic valve reimplantation technique was carried out with a low surgical risk and a low degree of residual aortic regurgitation in aneurysm of the aortic root, aneurysm of the ascending aorta and type A dissection with major destruction of the aortic root.
Afd. Thoraxchirurgie, St. Antoniusziekenhuis, CM Nieuwegein.
F P
FP
Casselman
I
I
Deblier
J M
JM
Ernst
J J
JJ
Defauw
M A
MA
Schepens
W J
WJ
Morshuis
D000328:Adult; D017545:Aortic Aneurysm, Thoracic / Q000503:physiopathology / Q000601:surgery*; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging / Q000601:surgery*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D002315:Cardiopulmonary Bypass; D004452:Echocardiography / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D012008:Recurrence; D012092:Replantation; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome