Long-term results of the valve reimplantation technique using a graft with sinuses.
OBJECTIVE
Aortic valve reimplantation is the most commonly used technique to spare the aortic valve. Long-term results data are scarce and available only with the use of standard straight graft. We examined the long-term results of reimplantation of the aortic valve using a graft incorporating sinuses of Valsalva.


METHODS
From May 2000 to December 2014, 124 patients had an aortic valve reimplanted into a graft with sinuses of Valsalva. The mean age was 53 ± 13 years and the majority were men (87%). Marfan syndrome was present in 21 patients (17%) and 12% had a bicuspid valve. Patients were prospectively followed by means of transthoracic echocardiography. The mean follow-up was 63 ± 52 months.


RESULTS
Overall survival at 5, 10, and 13 years was 94.4% ± 2.2%, 90.5% ± 4.4%, and 81.4% ± 7.3%, respectively. Six patients required reoperation within a time frame of 6 to 96 months. None of the patients died at reoperation. Freedom from reoperation was 95.4% ± 2.3% at 5 years and 90.1% ± 4.3% at 10 and 13 years. All patients who needed reoperation had surgery during the first 5 years. Three patients had residual aortic insufficiency >2. Considering also all patients who underwent reoperation because of aortic insufficiency, freedom from moderate to severe residual aortic insufficiency was 94.1% ± 2.6% at 5 years, and 87.1% ± 4.7% at 10 and 13 years.


CONCLUSIONS
The majority of patients who had their valve reimplanted in a graft with sinuses continue to perform well after 10 years.
Cardiac Surgery Department, European Hospital, Rome, Italy. Electronic address: depauli@tin.it.
Ruggero
R
De Paulis
Cardiac Surgery Department, European Hospital, Rome, Italy.
Ilaria
I
Chirichilli
Cardiac Surgery Department, European Hospital, Rome, Italy.
Raffaele
R
Scaffa
Cardiac Surgery Department, European Hospital, Rome, Italy.
Luca
L
Weltert
Cardiac Surgery Department, European Hospital, Rome, Italy.
Daniele
D
Maselli
Cardiac Surgery Department, European Hospital, Rome, Italy.
Andrea
A
Salica
Cardiac Surgery Department, European Hospital, Rome, Italy.
Lorenzo
L
Guerrieri Wolf
Clinica Mediterranea, Naples, Italy.
Alessandro
A
Bellisario
Cardiac Surgery Department, European Hospital, Rome, Italy.
Luigi
L
Chiariello
D000293:Adolescent; D000328:Adult; D000368:Aged; D001014:Aortic Aneurysm / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000209:etiology / Q000601:surgery; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011474:Prosthesis Design; D012086:Reoperation; D012092:Replantation / Q000009:adverse effects; D012307:Risk Factors; D012850:Sinus of Valsalva / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography; D055815:Young Adult
aortic root; aortic valve; valve repair