Aortic valve repair for congenital abnormalities of the aortic valve.
BACKGROUND
Due to shortcomings of any valve replacement, repairing and retaining the native valve may be beneficial for congenital aortic valve disease.


METHODS
Retrospective review of data and follow-up of aortic valve repair from a single institution.


RESULTS
From 1993 to 2001, 56 patients underwent aortic valve repair [median age 13.4 years (range 1 day to 45 years)]. The predominant aortic valve lesion was mixed aortic stenosis/aortic insufficiency 25 (45%), aortic insufficiency 24 (43%) and aortic stenosis 7 (13%). Repair techniques included sub-commissural plication 36 (64%), commissurotomy 24 (43%), cusp plication 15 (27%), pericardial patch cusp extension 8 (14%) and resuspension of commissures 4 (7%). Most patients (88%) required a combination of techniques; 61% required additional procedures. Hospital survival was 55/56 [98%; (95% CI 91-100%)] no patient was discharged on anticoagulation for aortic valve pathology. Fifty-three patients [95%; (95% CI 85-98%)] remain alive after a median follow-up of 37 months; four survivors required aortic valve replacement and two required repeat aortic valve repair [84%; (95% CI 72-91%) reintervention-free survival].


CONCLUSIONS
(1) In this study, aortic valve repair for congenital abnormalities avoided reoperation in the majority of patients, avoided anticoagulation and retained growth potential of the valve. (2) Repeat aortic valve repair or replacement was used to treat subsequent valve deterioration.
Quader
Mohammed A
MA
Department of Pediatric and Congenital Heart Surgery/M41, Children's Hospital, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
Rosenthal
Geoffrey L
GL
Qureshi
Athar M
AM
Mee
Roger B B
RB
Mumtaz
Muhammed A
MA
Joshi
Raja
R
Duncan
Brian W
BW
D000293:Adolescent; D000328:Adult; D000925:Anticoagulants / Q000009:adverse effects; D001021:Aortic Valve / Q000002:abnormalities* / Q000503:physiopathology / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000151:congenital* / Q000503:physiopathology / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000151:congenital* / Q000503:physiopathology / Q000601:surgery*; D006348:Cardiac Surgical Procedures / Q000379:methods; D002648:Child; D002675:Child, Preschool; D004696:Endocarditis / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000379:methods; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies
D000925:Anticoagulants