Aortic valve-sparing operations in patients with aneurysms of the aortic root or ascending aorta: preliminary results.
OBJECTIVE
Aortic valve-sparing operations were developed to preserve the native aortic valve in patients with aneurysms of the aortic root or ascending aorta and normal aortic valve leaflets. This paper describes our initial experience with valve-sparing operations and early clinical and echocardiographic results obtained.


METHODS
From October 2002 to March 2004, 32 consecutive patients underwent aortic valve-sparing operations at the Istituto Clinico Humanitas, Rozzano, Italy. Preoperative transesophageal echocardiography showed moderate or severe aortic incompetence (AI) in 15 patients (47%). Twenty-nine patients underwent reimplantation of the aortic valve and 3 patients remodeling of one sinus. In 2 cases prolapsing cusp repair was carried out.


RESULTS
There were no intraoperative deaths. At discharge, two-dimensional echocardiogram showed no or trivial aortic incompetence (AI) in 17 (52%) patients and mild AI in 13 (42%); 2 (6%) patients had severe AI requiring reoperation, respectively 4 and 6 weeks later.


CONCLUSIONS
The valve-sparing procedures showed good preliminary results, thus encouraging further use of this type of repair. However, further larger studies and long-term results are needed in order to define the durability of these techniques.
Department of Cardiac Surgery, Istituto Clinico Humanitas, Via Manzoni 56, cap: 20089, Rozzano (MI), Italy. sieben2000@yahoo.com
Fabrizio
F
Settepani
Diego
D
Ornaghi
Alessandro
A
Barbone
Enrico
E
Citterio
Alessandro
A
Eusebio
Eric
E
Manasse
Giuseppe
G
Silvaggio
Roberto
R
Gallotti