Repair of trileaflet aortic valve prolapse: mid-term outcome in patients with normal aortic root morphology.
We described our mid-term results in repairing prolapsing aortic cusps in 21 patients with aortic regurgitation and normal aortic root morphology. Aortic regurgitation was moderate-severe in five patients and severe in 16 patients. Prolapse involved the left cusp in four patients (19%), the right cusp in 10 patients (47%) and the non-coronary cusp in 7 (33%) patients. Correction of the prolapsing cusp was achieved by either free edge plication, triangular resection or resuspension with polytetrafluoroethylene sutures, frequently associated to a subcommissural annuloplasty. There was no hospital death. At discharge transthoracic echocardiography, 18 patients (85%) showed no residual aortic regurgitation and three patients (14%) had trivial aortic regurgitation with a central jet. Mean clinical follow-up was 27.2+/-17.1 months (range: 10-72 months). Overall survival was 90.5%. At follow-up transthoracic echocardiography, fourteen patients (73%) were free from aortic regurgitation and five patients (26%) had mild aortic regurgitation without clinical signs of congestive heart failure. Correction of valve prolapse appears a reasonable extension of the original techniques of valve-preserving surgery.
Department of Thoracic and Cardiovascular Surgery, Saint Luc Hospital, Université Catholique de Louvain, avenue Hippocrate 10, 1200 Brussels, Belgium. bruno_chiappini@hotmail.com
Bruno
B
Chiappini
Anne-Catherine
AC
Pouleur
Philippe
P
Noirhomme
Jean-Christophe
JC
Funken
Parla
P
Astarci
Robert
R
Verhelst
Alain
A
Poncelet
Gebrine
G
Elkhoury
D000328:Adult; D000368:Aged; D001022:Aortic Valve Insufficiency / Q000209:etiology / Q000601:surgery; D001023:Aortic Valve Prolapse / Q000150:complications / Q000601:surgery*; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D012086:Reoperation; D015996:Survival Rate; D013536:Suture Techniques; D016896:Treatment Outcome
D011138:Polytetrafluoroethylene