title: Aortic valve reconstruction with leaflet replacement and sinotubular junction fixation: early and midterm results.
abstract: BACKGROUND
  Aortic valve reconstruction surgery (AVRS), consisting of aortic leaflet reconstruction with tailored pericardial patches and fixation of the sinotubular junction with properly sized fabric rings, is performed for the treatment of aortic valve diseases. The early and midterm outcomes of AVRS were analyzed.
  
  
  METHODS
  Between December 2007 and December 2012, 262 patients with isolated aortic valve disease underwent AVRS in one center. Clinical outcomes, effective orifice area, mean gradients, and left ventricular mass index were evaluated yearly.
  
  
  RESULTS
  Mean follow-up duration was 36.0±17.1 months and was complete in 100% of surviving patients. There was no hospital mortality, but there were 3 late deaths (1.1% late mortality). Seven patients (2.7%) required reoperation: 5 because of endocarditis and 2 because of suture disruption of the leaflets. Ten patients (3.8%) experienced neurologic events. Aortic valve regurgitation was absent or trivial in 226 patients (87.3%) and mild in 29 (11.2%), mild to moderate in 3 (1.2%), and moderate to severe in 1 (0.4%). The mean valve gradient and valve orifice index were 10.6±5.3 mm Hg and 1.3±0.4 cm2/m2, respectively.
  
  
  CONCLUSIONS
  The data from the first 5 years after AVRS reveal good clinical and hemodynamic outcomes, suggesting that AVRS is a new alternative technique to the practice of replacement with stented bioprostheses and mechanical prostheses. However, whether the reconstructed aortic valve represents a truly long-term valve remains to be demonstrated.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, South Korea.
authors.forename: Meong Gun
authors.initials: MG
authors.lastname: Song
authors.affiliation: Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, South Korea.
authors.forename: Hyun Suk
authors.initials: HS
authors.lastname: Yang
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Chonbuk National University Medical School, Jeonju, South Korea. Electronic address: jobchoi@jbnu.ac.kr.
authors.forename: Jong Bum
authors.initials: JB
authors.lastname: Choi
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Inje University Medical School, Paik General Hospital, Seoul, South Korea.
authors.forename: Yong In
authors.initials: YI
authors.lastname: Kim
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, South Korea.
authors.forename: Je Kyoun
authors.initials: JK
authors.lastname: Shin
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, South Korea.
authors.forename: Hyun Keun
authors.initials: HK
authors.lastname: Chee
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, South Korea.
authors.forename: Jun Seok
authors.initials: JS
authors.lastname: Kim
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, College of Medicine, Yeungnam University, Daegu, South Korea.
authors.forename: Dong Hyup
authors.initials: DH
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery; D000082882:Bicuspid Aortic Valve Disease; D006348:Cardiac Surgical Procedures / Q000379:methods; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery*; D006349:Heart Valve Diseases / Q000601:surgery*; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult