title: Aortic valve repair: a ten-year single-centre experience†.
abstract: OBJECTIVE
  Aortic valvuloplasty could represent an alternative to valve replacement resulting in optimal haemodynamic conditions, avoiding anticoagulation and allowing, in young people, normal aortic annulus growth. We analysed our results of aortic valve repair for incompetence due to leaflets and root pathology.
  
  
  METHODS
  From January 2003 to January 2013, 235 patients affected by aortic valve regurgitation, pure or associated with aortic dilatation, were treated with a combination of the principal leaflet repair techniques and, when necessary, sparing procedures. Of these patients, 218 were considered eligible in this study. All of them were submitted to pre- and postoperative transthoracic echocardiography and pre- and post-repair transoesophageal echocardiography. Follow-up was achieved with periodic echocardiograms and clinical evaluations.
  
  
  RESULTS
  Eight patients (3.40%) died before discharge. Median clinical and echocardiographic follow-up for all patients was 2.94 (1.41-5.41) years. Mean cross-clamping time was 101.94 ± 40.22 min and mean hospital stay was 10 ± 6.69 days. Kaplan-Meier freedom from aortic regurgitation >2 and freedom from aortic valve replacement were, respectively, 92.9 ± 2.8 and 94.5 ± 2.5% at 9.24 years: 6 patients (2.75%) were reoperated on with aortic valve replacement for severe aortic regurgitation. We also observed a good effect of aortic surgery on the left ventricle: the end-diastolic volume decreased from 137.89 ± 50.23 ml in the preop to 105.17 ± 31.19 ml at follow-up.
  
  
  CONCLUSIONS
  Aortic valve leaflet repair seems to be a good and feasible option for selected patients, both alone or associated with an aortic sparing technique concerning long-term results.
authors.affiliation: Cardio-Cerebro-Vascular Department, 'L. Sacco' University General Hospital, Milan, Italy Dipartimento di Elettronica, Informatica e Bioingegneria (DEIB) Politecnico di Milano, Milan, Italy mangini.andrea@hsacco.it.
authors.forename: Andrea
authors.initials: A
authors.lastname: Mangini
authors.affiliation: Cardio-Cerebro-Vascular Department, 'L. Sacco' University General Hospital, Milan, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Contino
authors.affiliation: Cardio-Cerebro-Vascular Department, 'L. Sacco' University General Hospital, Milan, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Romagnoni
authors.affiliation: Cardio-Cerebro-Vascular Department, 'L. Sacco' University General Hospital, Milan, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Lemma
authors.affiliation: Cardio-Cerebro-Vascular Department, 'L. Sacco' University General Hospital, Milan, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: Gelpi
authors.affiliation: Cardio-Cerebro-Vascular Department, 'L. Sacco' University General Hospital, Milan, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Vanelli
authors.affiliation: Cardio-Cerebro-Vascular Department, 'L. Sacco' University General Hospital, Milan, Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Colombo
authors.affiliation: Cardio-Cerebro-Vascular Department, 'L. Sacco' University General Hospital, Milan, Italy Università Degli Studi di Milano, Milan, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Antona
mesh_terms: D000328:Adult; D000368:Aged; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D002983:Clinical Competence; D017548:Echocardiography, Transesophageal; D005260:Female; D019918:Heart Valve Prosthesis Implantation; D006439:Hemodynamics; D017052:Hospital Mortality; D006801:Humans; D007558:Italy; D053208:Kaplan-Meier Estimate; D059032:Learning Curve; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality / Q000601:surgery; D011446:Prospective Studies; D012086:Reoperation; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
keywords: Aortic root; Aortic valve repair