title: Early and medium term results of the sleeve valve-sparing procedure for aortic root ectasia.
abstract: BACKGROUND
  The aim of this retrospective study was to evaluate our experience of using a simplified aortic valve sleeve procedure to treat aortic root ectasia and aneurysms with or without aortic regurgitation. In experienced hands, 2 aortic valve-sparing procedures, ie, Yacoub and David, have yielded excellent long-term results in the treatment of aortic root aneurysms, with or without aortic regurgitation. However, these techniques are demanding and not widely used. Recently, a new and simplified valve-sparing technique, named "sleeve procedure," has been proposed, and has yielded encouraging early results.
  
  
  METHODS
  Ninety consecutive patients with aortic root aneurysms underwent sleeve procedures from October 2006 to October 2012. Follow-up data (clinical 100% complete and echocardiographic 93% complete) were acquired from our outpatient clinic or from the referring cardiologist.
  
  
  RESULTS
  The mean age of the patients was 61.5 ± 12.5 years, 79% were male, 16 (18%) had a bicuspid valve, 3 had Marfan syndrome, and 2 had aortic dissection. Over a mean clinical follow-up of 34 ± 19 months, 2 patients died from noncardiac causes and 1 was reoperated on for the recurrence of aortic regurgitation. On follow-up echocardiography after a mean of 18 ± 9 months, aortic regurgitation was absent/negligible, mild or moderate in 62%, 37%, and 1% of patients, respectively, and the diameters of the annulus, Valsalva sinuses, and sinotubular junction were 27.3 + 2.2, 37.0 + 3.4, and 30.6 + 3.1 mm, respectively.
  
  
  CONCLUSIONS
  Our encouraging early and medium term results suggest that the sleeve procedure is a safe and effective aortic valve-sparing technique for the treatment of aortic root ectasia and aneurysm. However, longer follow-up is needed in order to draw definitive conclusions.
authors: Cardiovascular Department, Operative Unit of Cardiac Surgery, Ospedale "A. Manzoni" di Lecco, Lecco, Italy.
authors: Amando
authors: A
authors: Gamba
authors: Cardiovascular Department, Operative Unit of Cardiac Surgery, Ospedale "A. Manzoni" di Lecco, Lecco, Italy. Electronic address: giordano.tasca67@gmail.com.
authors: Giordano
authors: G
authors: Tasca
authors: Cardiovascular Department, Operative Unit of Cardiac Surgery, Ospedale "A. Manzoni" di Lecco, Lecco, Italy.
authors: Floriana
authors: F
authors: Giannico
authors: Operative Unit of Cardiology, Ospedale "A. Manzoni" di Lecco, Lecco, Italy.
authors: Elisabetta
authors: E
authors: Lobiati
authors: Operative Unit of Cardiology, Ospedale "A. Manzoni" di Lecco, Lecco, Italy.
authors: Douglas
authors: D
authors: Skouse
authors: Cardiovascular Department, Operative Unit of Cardiac Surgery, Ospedale "A. Manzoni" di Lecco, Lecco, Italy.
authors: Andrea
authors: A
authors: Galanti
authors: Cardiovascular Department, Operative Unit of Cardiac Surgery, Ospedale "A. Manzoni" di Lecco, Lecco, Italy.
authors: Antonello Stefano
authors: AS
authors: Martino
authors: Cardiovascular Department, Operative Unit of Cardiac Surgery, Ospedale "A. Manzoni" di Lecco, Lecco, Italy.
authors: Michele
authors: M
authors: Triggiani
mesh_terms: D000368:Aged; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000601:surgery*; D058385:Cardiac Valve Annuloplasty / Q000379:methods*; D015331:Cohort Studies; D004108:Dilatation, Pathologic / Q000473:pathology / Q000601:surgery; D015150:Echocardiography, Doppler / Q000379:methods; D005112:Extracorporeal Circulation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D059351:Organ Sparing Treatments / Q000379:methods*; D061214:Patient Safety; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D012189:Retrospective Studies; D018570:Risk Assessment; D056346:Sternotomy / Q000379:methods; D013536:Suture Techniques; D013997:Time Factors; D016896:Treatment Outcome