title: Early outcomes using the Florida sleeve repair for correction of aortic insufficiency due to root aneurysms.
abstract: BACKGROUND
  The Florida sleeve procedure is a simplified valve-sparing technique for repair of functional type I aortic insufficiency associated with root aneurysms. Midterm outcomes are reported, including standard echocardiographic measurements.
  
  
  METHODS
  The study included all patients undergoing the Florida sleeve procedure who had at least 2 years of postoperative echocardiographic follow-up. Data were acquired preoperatively and postoperatively at 1 week and 1, 2, and 3 years. Measurements analyzed included left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), and degree of aortic insufficiency.
  
  
  RESULTS
  Complete echocardiographic data for a mean 32 +/- 6.3 months after repair were available for 18 patients. Mean LVEDD decreased from 51.6 +/- 7.4 to 49.7 +/- 6.3 mm at 1 week (p = 0.05) and 47.1 +/- 6.3 mm at 1 year (p = 0.008), and remained unchanged at 47.2 +/- 6.6 and 47.1 +/- 5.0 mm at 2 and 3 years. Mean LVESD decreased from 35.2 +/- 7.6 to 32.9 +/- 7.0 mm at 1 week (p = 0.002) and 30.7 +/- 5.6 mm at 1 year (p < 0.001), and remained unchanged at 30.9 +/- 6.2 and 31.7 +/- 4.9 mm after 2 and 3 years. The mean grade of aortic insufficiency decreased from 2.61 +/- 0.78 to 1.39 +/- 0.85 mm at 1 week (p < 0.001) and remained 1.39 +/- 0.84 mm at 1 year. Aortic insufficiency increased to 1.72 +/- 0.89 (p = 0.03) at 2 years and decreased to 1.67 +/- 0.50 (p = 0.59, from 1 week postoperatively) at 3 years.
  
  
  CONCLUSIONS
  The sustained reduction of left ventricular dimensions 3 years after operation suggests the Florida sleeve procedure is a durable valve repair. A minor increase in the degree of aortic insufficiency warrants close follow-up, but the absence of an increase of LVEDD supports continued use of the procedure in closely studied series.
authors.affiliation: Division of Thoracic and Cardiovascular Surgery, University of Florida, College of Medicine, Gainesville, Florida 32610, USA. hesspj@surgery.ufl.edu
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Hess
authors.forename: P Kent
authors.initials: PK
authors.lastname: Harman
authors.forename: Charles T
authors.initials: CT
authors.lastname: Klodell
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Beaver
authors.forename: Marco T
authors.initials: MT
authors.lastname: Bologna
authors.forename: Peter
authors.initials: P
authors.lastname: Mikhail
authors.forename: Curtis G
authors.initials: CG
authors.lastname: Tribble
authors.forename: Tomas D
authors.initials: TD
authors.lastname: Martin