title: Initial Surgical Experience with Aortic Valve Repair: Clinical and Echocardiographic Results.
abstract: Due to late complications associated with the use of conventional prosthetic heart valves, several centers have advocated aortic valve repair and/or valve sparing aortic root replacement for patients with aortic valve insufficiency, in order to enhance late survival and minimize adverse postoperative events.
  
  
  
  From March/2012 thru March 2015, 37 patients consecutively underwent conservative operations of the aortic valve and/or aortic root. Mean age was 48±16 years and 81% were males. The aortic valve was bicuspid in 54% and tricuspid in the remaining. All were operated with the aid of intraoperative transesophageal echocardiography. Surgical techniques consisted of replacing the aortic root with a Dacron graft whenever it was dilated or aneurysmatic, using either the remodeling or the reimplantation technique, besides correcting leaflet prolapse when present. Patients were sequentially evaluated with clinical and echocardiographic studies and mean follow-up time was 16±5 months.
  
  
  
  Thirty-day mortality was 2.7%. In addition there were two late deaths, with late survival being 85% (CI 95% - 68%-95%) at two years. Two patients were reoperated due to primary structural valve failure. Freedom from reoperation or from primary structural valve failure was 90% (CI 95% - 66%-97%) and 91% (CI 95% - 69%-97%) at 2 years, respectively. During clinical follow-up up to 3 years, there were no cases of thromboembolism, hemorrhage or endocarditis.
  
  
  
  Although this represents an initial series, these data demonstrates that aortic valve repair and/or valve sparing aortic root surgery can be performed with satisfactory immediate and short-term results.
authors.affiliation: Pontifícia Universidade Católica do Paraná, Curitiba, PR, Brazil.
authors.forename: Francisco Diniz Affonso
authors.initials: FDA
authors.lastname: da Costa
authors.affiliation: Pontifícia Universidade Católica do Paraná, Curitiba, PR, Brazil.
authors.forename: Daniele de Fátima Fornazari
authors.initials: Dde F
authors.lastname: Colatusso
authors.affiliation: Mount Sinai Hospital, New York, USA.
authors.forename: Ana Claudia Brenner Affonso
authors.initials: ACBA
authors.lastname: da Costa
authors.affiliation: Instituto de Neurologia e Cardiologia de Curitiba, Curitiba, PR, Brazil.
authors.forename: Eduardo Mendel
authors.initials: EM
authors.lastname: Balbi Filho
authors.affiliation: Hospital Irmandade Santa Casa de Curitiba, Curitiba, PR, Brazil.
authors.forename: Vinicius Nesi
authors.initials: VN
authors.lastname: Cavicchioli
authors.affiliation: Hospital Irmandade Santa Casa de Curitiba, Curitiba, PR, Brazil.
authors.forename: Sergio Augusto Veiga
authors.initials: SA
authors.lastname: Lopes
authors.affiliation: Hospital Irmandade Santa Casa de Curitiba, Curitiba, PR, Brazil.
authors.forename: Andrea Dumsch de Aragon
authors.initials: AD
authors.lastname: Ferreira
authors.affiliation: Pontifícia Universidade Católica do Paraná, Curitiba, PR, Brazil.
authors.forename: Claudinei
authors.initials: C
authors.lastname: Collatusso
mesh_terms: D000328:Adult; D000368:Aged; D001021:Aortic Valve / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D000082882:Bicuspid Aortic Valve Disease; D018572:Disease-Free Survival; D017548:Echocardiography, Transesophageal / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012086:Reoperation / Q000706:statistics & numerical data; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult