Novel technique of aortic valvuloplasty.
OBJECTIVE
The present study was aimed to assess the results of newly developed aortic valve repair technique.


METHODS
Between 1997 and 2004, 69 aortic valvuloplasties were performed with a new technique addressing the three main components of the aortic root; leaflets (L), sinotubular junction (STJ), and aortic annulus (A). For leaflet correction, additional leaflets were implanted and for STJ and annular reduction, an internal synthetic ring and strip along the fibrous annulus were implanted, respectively. The patients were divided into two groups: 30 patients with isolated aortic regurgitation (group IAR) were treated by correction of STJ+L (n=21) and STJ+A+L (n=9), and 39 aortic regurgitation patients with annuloaortic ectasia or ascending aortic aneurysm (group AAR) were treated with STJ correction only (n=16), STJ+A (n=6), STJ+L (n=9), and STJ+A+L (n=8).


RESULTS
The mean age was 43.4 and 49.5 years for groups IAR and AAR, respectively. There was neither operative nor follow-up death in either group. Suture breakage caused one reoperation in group IAR. Mean follow-up was 13.8 and 20.3 months in groups IAR and AAR, respectively. The preoperative aortic regurgitation grade was 3.67 in group IAR and 2.67 in group AAR. The last follow-up aortic regurgitation grade was 1.1 in group IAR and 1.05 in group AAR. No patient, except for the reoperated patient had AR greater than grade 2. The postoperative pressure gradient was 19.3 mmHg in group IAR and 8. 4mmHg in group AAR.


CONCLUSIONS
The results showed this technique to be safe and effective. Thus far broad application of this repair technique has been demonstrated to be highly feasible.
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan, Seoul, Republic of Korea.
Shee Young
SY
Hahm
Suk Jung
SJ
Choo
Jae Won
JW
Lee
Joon Beom
JB
Seo
Tae Hwan
TH
Lim
Jae Kwan
JK
Song
Je Kyoun
JK
Shin
Meong Gun
MG
Song
D000328:Adult; D001014:Aortic Aneurysm / Q000601:surgery; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D002315:Cardiopulmonary Bypass / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008382:Marfan Syndrome / Q000601:surgery; D008875:Middle Aged; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014463:Ultrasonography; D016277:Ventricular Function, Left