title: Long-term results of the leaflet extension technique in aortic regurgitation: thirteen years of experience in a single center.
abstract: BACKGROUND
  We evaluated the effectiveness and durability of the leaflet extension technique for correction of aortic regurgitation (AR) and the long-term clinical results.
  
  
  METHODS
  Between March 1995 and August 2004, 41 consecutive patients were included. The mean age was 32.2 +/- 13.9 years. The causes of AR were rheumatic in 31 patients (75.5%), degenerative in 2 patients (4.9%), bicuspid aortic valve in 4 patients (9.8%), infective endocarditis in 1 patient (2.4%), and congenital in 3 patients (7.3%). Leaflet extensions were performed in three leaflets for 32 patients, two leaflets for 3 patients, and only one leaflet for 6 patients. The mean follow-up duration was 92.9 +/- 48.4 months.
  
  
  RESULTS
  There were no early deaths and 2 late deaths. One patient died of cancer and the other patient died of infective endocarditis. The cardiac-related mortality was 2.4% (1 of 41 patients). During a mean follow-up of 7 years, severe AR was detected in 1 patient and moderate AR in 6 patients (17.0%; 7 of 41 patients). The causes of recurrent AR were infective endocarditis in 3 patients, disease progression in 3 patients, and Behçet's diseases in 1 patient. We performed 6 reoperations (14.6%), 3 in patients owing to infective endocarditis, 2 in patients owing to disease progression, and 1 in a patient owing to the suture dehiscence associated with Behçet's disease. The cumulative survival was 92.6% at 13 years. Freedom from recurrent AR was 97.5% at 5 years, 81.7% at 10 years, and 68.1% at 13 years.
  
  
  CONCLUSIONS
  The long-term durability of the leaflet extension technique was acceptable. The reoperations increased with time, but pericardial leaflet dysfunction was not the cause.
authors: Department of Thoracic and Cardiovascular Surgery, Seoul National University Borame Medical Center, Seoul, South Korea.
authors: Dong Seop
authors: DS
authors: Jeong
authors: Kyung-Hwan
authors: KH
authors: Kim
authors: Hyun
authors: H
authors: Ahn
mesh_terms: D000328:Adult; D000367:Age Factors; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D006348:Cardiac Surgical Procedures / Q000379:methods* / Q000401:mortality; D002815:Chordae Tendineae / Q000601:surgery*; D015331:Cohort Studies; D015150:Echocardiography, Doppler; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D010496:Pericardium / Q000637:transplantation*; D011183:Postoperative Complications / Q000401:mortality; D011379:Prognosis; D019651:Plastic Surgery Procedures / Q000379:methods / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016019:Survival Analysis; D013997:Time Factors; D014182:Transplantation, Autologous; D055815:Young Adult