Aortic Valve-sparing Operation with Reimplantation Technique

María Carolina Escarain, María Paula Duczynski, Gerardo Edgar Bozovich, Roberto René Favaloro


Introduction: The aortic valve-sparing operation offers the unique possibility of preserving the native valve in patients whoneed surgical treatment for aortic root disease.

Objective: The aim of this study was to assess the long term outcome of the aortic valve-sparing operation with reimplantation technique at the Hospital Universitario Fundación Favaloro.

Methods: A total of 66 patients underwent aortic valve-sparing operation from June 1998 to December 2011. Fifty threepatients operated on with the aortic valve reimplantation technique were included in the study and 13 patients operatedwith the remodeling technique were excluded. Clinical and echocardiographic follow-up was performed. Aortic insufficiencywas graded as: 0: absent; 1+: mild; 2+: moderate; 3+: moderate-severe, and 4+: severe. Survival and freedom from aorticinsufficiency >2+ and reoperation were analyzed using the Kaplan-Meier method.Results: Mean age was 45±17 years, 79% of patients were men and 36% had Marfan syndrome. In-hospital and late mortalitywas 3.8%. Survival at 8 years was 91% (95% CI: 78-97%). Freedom from aortic insufficiency > 2+ and reoperation at 8 yearswas 84% (95% CI: 66-92%) and 90% (95% CI: 74-96%), respectively. Preoperative aortic insufficiency >2+ was not associatedwith aortic insufficiency >2+ (RR 1.45; p=0.16) or reoperation (RR 1.96; p=0.4) during follow-up.

Conclusions: In our experience, the aortic valve-sparing operation with reimplantation technique in patients with aortic rootdisease shows comparable results to other published international series. This surgical technique is a valid option for eligiblepatients duly informed about the different surgical techniques, and should be performed in experienced centers.

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Revista argentina de cardiología. ISSN en línea 1850-3748. Argentine journal of cardiology (English ed. Online ISSN 2314-2286) Sociedad Argentina de Cardiología. Azcuénaga 980 (C1115AAD),Ciudad Autónoma de Buenos Aires, República Argentina. Tel. (54 11) 4961-6027/8/9 Fax: 4961-6020