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Masamichi Ono
Heidi Goerler
Klaus Kallenbach
Dietmar Boethig
Thomas Breymann
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J Thorac Cardiovasc Surg 2007;133:876-879
© 2007 The American Association for Thoracic Surgery

Surgery for Congenital Heart Disease

Aortic valve–sparing reimplantation for dilatation of the ascending aorta and aortic regurgitation late after repair of congenital heart disease

Masamichi Ono, MDa,*, Heidi Goerler, MDa, Klaus Kallenbach, MDa, Dietmar Boethig, MDb, Mechthild Westhoff-Bleck, MDc, Thomas Breymann, MDa

a Division of Thoracic and Cardiovascular Surgery, Hannover Medical School, Hannover, Germany
b Division of Pediatric Cardiology, Intensive Care Medicine, Hannover Medical School, Hannover, Germany
c Division of Cardiology, Hannover Medical School, Hannover, Germany.

Received for publication October 20, 2006; accepted for publication October 30, 2006.

* Address for reprints: Masamichi Ono, MD, Division of Thoracic and Cardiovascular Surgery, Hannover Medical School, Carl-Neuberg-Str 1, 30625 Hannover, Germany. (Email: Ono.Masamichi{at}mh-hannover.de).

Objective: Aortic regurgitation resulting from progressive dilatation of the aortic root late after surgical correction of congenital heart disease is now widely recognized. We reviewed our experience with aortic valve–sparing operations to access the effectiveness of this approach.

Methods: Three patients, aged 28, 31, and 32 years, had progressive dilatation of the ascending aorta and aortic regurgitation 25, 27, and 28 years, respectively, after surgical repair of complex congenital heart disease. At the time of reoperation, the maximum diameter of the aortic root ranged between 50 and 55 mm.

Results: All 3 patients survived the operation and were in New York Heart Association functional class II or less at a maximum of 9 years’ follow-up. The most recent echocardiogram demonstrated mild or less aortic insufficiency with favorable systemic ventricular function.

Conclusions: Aortic valve–sparing reimplantation is an effective treatment for aortic root dilatation and aortic regurgitation after corrective repair of complex congenital heart disease. This procedure leads to correction of aortic regurgitation, favorable durability of the native aortic valve, and excellent hemodynamics, avoiding a prosthetic valve and anticoagulation.

Abbreviations and Acronyms AR = aortic regurgitation; CHD = congenital heart disease; TOF = tetralogy of Fallot






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