Valve-sparing aortic root repair with patch technique.
BACKGROUND
In the valve-sparing aortic root repair technique presented, each pathologic sinus is replaced with a teardrop-shaped patch. In this study, the clinical and echocardiographic results after the first 20 procedures are evaluated.


METHODS
Between September 2000 and May 2004, 20 patients underwent aortic root repair using a patch technique. Eight patients had an acute type A aortic dissection and 12 patients had an aneurysm of the ascending aorta. In 12 cases, the aortic root was reconstructed with three patches, in 1 case with two patches, and in 7 cases with one patch.


RESULTS
The postoperative echocardiography at discharge showed no aortic regurgitation in 15 cases and trivial regurgitation in 5 cases. Three patients with aortic dissection as an initial pathologic diagnosis died during a median follow-up period of 14.5 months (range, 0.5 to 32 months). At the time of follow-up, the echocardiographic findings in all 17 survivors remained unchanged from the early postoperative examinations. Median peak and mean transvalvular gradients were 8 mm Hg (range, 3.2 to 14 mm Hg) and 4 mm Hg (range, 1.7 to 6 mm Hg), respectively.


CONCLUSIONS
The technique presented allows an individualized reconstruction of the sinuses of Valsalva, a simplified sizing of the vascular graft, and the creation of a new sinotubular junction resulting in good hemodynamic conditions. The technique is especially advantageous in patients in whom replacement of all sinuses is not necessary.
Urbanski
Paul P
PP
Department of Cardiovascular Surgery, Cardiovascular Center Bad Neustadt, Bad Neustadt, Germany. p.urbanski@herzchirurgie.de
D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000601:surgery*; D001014:Aortic Aneurysm / Q000401:mortality / Q000601:surgery*; D001021:Aortic Valve / Q000601:surgery; D006348:Cardiac Surgical Procedures / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016019:Survival Analysis