| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
J Thorac Cardiovasc Surg 2004;127:645-653
© 2004 The American Association for Thoracic Surgery
Surgery for acquired cardiovascular disease |
a Division of Cardiovascular Surgery, Mayo Clinic and Foundation, Rochester, Minn, USA
Read at the Eighty-third Annual Meeting of The American Association for Thoracic Surgery, Boston, Mass, May 4-7, 2003.
Received for publication June 11, 2003; revisions received August 15, 2003; accepted for publication September 12, 2003.
* Address for reprints: Hartzell V. Schaff, MD, 200 First Street SW, Rochester, MN 55905, USA
schaff{at}mayo.edu
OBJECTIVE: To assess outcome of valve repair in patients with aortic valve regurgitation with emphasis on incidence and risk of reoperation.
METHODS: We retrospectively reviewed 160 consecutive patients (127 men) who underwent aortic valve repair between 1986 and 2001. Ages ranged from 14 to 84 years (mean 55 ± 17 years). Patients were categorized according to the main etiology of valve disease; 63 patients (39%) had annular dilation leading to central leakage, 54 (34%) had bicuspid valve, 34 (21%) with tricuspid valve had cusp prolapse, and 9 (6%) had cusp perforation. Repair methods included commissural plication (n = 154, 96%), partial cusp resection with plication (n = 47, 29%), resuspension or cusp shortening (n = 44, 28%), and closure of cusp perforation (n = 10, 6%).
RESULTS: There was 1 early death (0.6%). Two patients required re-repair of the aortic valve during initial hospitalization. During a mean follow-up of 4.2 years, there were 16 late deaths. Overall, 16 of 159 hospital survivors had late reoperation on the aortic valve (mean interval 2.8 years) without early mortality. Risks of reoperation on the aortic valve were 9%, 11%, and 15% at 3, 5, and 7 years, respectively.
CONCLUSIONS: Aortic valve repair can be performed with low risk and excellent freedom from valve-related morbidity and mortality. Late recurrence of aortic valve regurgitation led to reoperation in 8.8% of patients, but mortality associated with subsequent procedures is low. Aortic valve repair appears to be a good option for selected patients, particularly young patients who wish to avoid chronic anticoagulation with warfarin.
This article has been cited by other articles:
|
|
 |
|
  J.-B. le Polain de Waroux, A.-C. Pouleur, A. Robert, A. Pasquet, B. L. Gerber, P. Noirhomme, G. El Khoury, and J.-L. J. Vanoverschelde Mechanisms of Recurrent Aortic Regurgitation After Aortic Valve Repair: Predictive Value of Intraoperative Transesophageal Echocardiography J. Am. Coll. Cardiol. Img., August 1, 2009; 2(8): 931 - 939. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. J. Hess Jr, P. K. Harman, C. T. Klodell, T. M. Beaver, M. T. Bologna, P. Mikhail, C. G. Tribble, and T. D. Martin Early Outcomes Using the Florida Sleeve Repair for Correction of Aortic Insufficiency due to Root Aneurysms Ann. Thorac. Surg., April 1, 2009; 87(4): 1161 - 1169. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 2006 WRITING COMMITTEE MEMBERS, R. O. Bonow, B. A. Carabello, K. Chatterjee, A. C. de Leon Jr, D. P. Faxon, M. D. Freed, W. H. Gaasch, B. W. Lytle, R. A. Nishimura, et al. 2008 Focused Update Incorporated Into the ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): Endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons Circulation, October 7, 2008; 118(15): e523 - e661. [Full Text] [PDF]
|
|
|
|
 |
|
 L. de Kerchove, D. Glineur, A. Poncelet, M. Boodhwani, J. Rubay, W. Dhoore, P. Noirhomme, and G. El Khoury Repair of aortic leaflet prolapse: a ten-year experience Eur. J. Cardiothorac. Surg., October 1, 2008; 34(4): 785 - 791. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. O. Bonow, B. A. Carabello, K. Chatterjee, A. C. de Leon Jr, D. P. Faxon, M. D. Freed, W. H. Gaasch, B. W. Lytle, R. A. Nishimura, P. T. O'Gara, et al. 2008 Focused Update Incorporated Into the ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease) Endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons J. Am. Coll. Cardiol., September 23, 2008; 52(13): e1 - e142. [Full Text] [PDF]
|
|
|
|
|
|
C. K. Park, P. W. Park, J.-H. Yang, Y. T. Lee, K. Sung, and W. S. Kim Intraventricular Patch Repair Through an Extended Aortotomy for Repeated Left Ventricular Rupture After Mitral Valve Replacement Ann. Thorac. Surg., September 1, 2008; 86(3): 1000 - 1002. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. B. Pettersson, A. C. Crucean, R. Savage, C. M. Halley, R. A. Grimm, L. G. Svensson, S. Naficy, A. M. Gillinov, J. Feng, and E. H. Blackstone Toward predictable repair of regurgitant aortic valves a systematic morphology-directed approach to bicommissural repair. J. Am. Coll. Cardiol., July 1, 2008; 52(1): 40 - 49. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Fattouch, R. Sampognaro, G. Bianco, E. Navarra, M. Moscarelli, G. Speziale, and G. Ruvolo Implantation of Gore-Tex Chordae on Aortic Valve Leaflet to Treat Prolapse Using "The Chordae Technique": Surgical Aspects and Clinical Results Ann. Thorac. Surg., June 1, 2008; 85(6): 2019 - 2024. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Zehr Invited Commentary Ann. Thorac. Surg., June 1, 2008; 85(6): 2024 - 2025. [Full Text] [PDF]
|
|
|
|
 |
|
 M. Enriquez-Sarano, V. T. Nkomo, and H. Michelena Principles and Practice of Echocardiography in Cardiac Surgery Card. Surg. Adult, January 1, 2008; 3(2008): 315 - 348. [Full Text]
|
|
|
|
|
|
J.-B. le Polain de Waroux, A.-C. Pouleur, C. Goffinet, D. Vancraeynest, M. Van Dyck, A. Robert, B. L. Gerber, A. Pasquet, G. E. Khoury, and J.-L. J. Vanoverschelde Functional Anatomy of Aortic Regurgitation: Accuracy, Prediction of Surgical Repairability, and Outcome Implications of Transesophageal Echocardiography Circulation, September 11, 2007; 116(11_suppl): I-264 - I-269. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. O. Bonow, B. A. Carabello, K. Chatterjee, A. C. de Leon Jr, D. P. Faxon, M. D. Freed, W. H. Gaasch, B. W. Lytle, R. A. Nishimura, P. T. O'Gara, et al. ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease) Developed in Collaboration With the Society of Cardiovascular Anesthesiologists Endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons J. Am. Coll. Cardiol., August 1, 2006; 48(3): e1 - e148. [Full Text] [PDF]
|
|
|
|
|
|
R. O. Bonow, B. A. Carabello, K. Chatterjee, A. C. de Leon Jr, D. P. Faxon, M. D. Freed, W. H. Gaasch, B. W. Lytle, R. A. Nishimura, P. T. O'Gara, et al. ACC/AHA 2006 Practice Guidelines for the Management of Patients With Valvular Heart Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease) Developed in Collaboration With the Society of Cardiovascular Anesthesiologists Endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons J. Am. Coll. Cardiol., August 1, 2006; 48(3): 598 - 675. [Full Text] [PDF]
|
|
|
|
|
|
S. Talwar, C. Saikrishna, A. Saxena, and A. Sampath Kumar Aortic Valve Repair for Rheumatic Aortic Valve Disease Ann. Thorac. Surg., June 1, 2005; 79(6): 1921 - 1925. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. H. Jones The Year in Cardiovascular Surgery J. Am. Coll. Cardiol., May 3, 2005; 45(9): 1517 - 1528. [Full Text] [PDF]
|
|
|
|
|
|
P. J. Nash, E. Vitvitsky, J. Li, D. M. Cosgrove III, G. Pettersson, and R. A. Grimm Feasibility of Valve Repair for Regurgitant Bicuspid Aortic Valves--An Echocardiographic Study Ann. Thorac. Surg., May 1, 2005; 79(5): 1473 - 1479. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. H. Rahimtoola The year in valvular heart disease J. Am. Coll. Cardiol., January 4, 2005; 45(1): 111 - 122. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
