HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): John Alfred Carr Edward B. Savage Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Carr, J. A. Articles by Savage, E. B. Search for Related Content PubMed PubMed Citation Articles by Carr, J. A. Articles by Savage, E. B. Related Collections Valve disease

Eur J Cardiothorac Surg 2004;25:6-15
© 2004 Elsevier Science NL

Review

Aortic valve repair for aortic insufficiency in adults: a contemporary review and comparison with replacement techniques

^a Department of Cardiovascular-Thoracic Surgery, Rush-Presbyterian-St. Luke's Medical Center, Rush Medical College, 1653 West Congress Parkway, Chicago, IL 60612, USA
^b Department of Cardiothoracic Surgery, John H. Stroger, Jr. Hospital of Cook County, Suite 1156, 1725 West Harrison Street, Chicago, IL 60612, USA

Received 10 July 2003; received in revised form 17 September 2003; accepted 22 September 2003.

^* Corresponding author. Tel.: +1-312-563-2762; fax: +1-312-563-4388
e-mail: chstcutter{at}aya.yale.edu

In evaluating the goal of aortic valve preservation, there have been 11 reports of large series of aortic valve repair for aortic insufficiency in adults published in recent years. We sought to analyze the validity of these methods and compare them to published results for bioprosthetic valves, pulmonary autografts, and aortic homografts. From 1990 to 2002, 761 adult aortic valve repairs were reported. Perioperative morbidity ranged from 3.6 to 23% (mean 14%), early mortality 0–8% (mean 3.6%), and late mortality 0–8% (mean 2.8%). The 5- and 10-year freedom from reoperation rates for repair were 89 and 64%. Although early results are good, long-term analysis suggests that, as a group, the durability of repair is unclear. Patients with rheumatic valvular disease appear to have an increased incidence of recurrence and repair failure. Although suture line dehiscence continues to be both an early and late complication with repair, the long-term morbidity and mortality is low and valve repair may be an option in carefully selected patients. However, the inability to break down the results by techniques does not allow for a definitive conclusion. Further subanalysis is necessary as larger series are reported. Proponents must attempt to separate successful from unsuccessful techniques. Aortic valve repair is a technique in evolution.

Key Words: Aortic valve • Valve repair • Aortic insufficiency • Aortic valve surgery • Valvuloplasty

This article has been cited by other articles:

				L. de Kerchove, M. Boodhwani, D. Glineur, A. Poncelet, R. Verhelst, P. Astarci, V. Lacroix, J. Rubay, M. Vandyck, J.-L. Vanoverschelde, et al. Effects of Preoperative Aortic Insufficiency on Outcome After Aortic Valve-Sparing Surgery Circulation, September 15, 2009; 120(11_suppl_1): S120 - S126. [Abstract] [Full Text] [PDF]

				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]

				H. Izumoto, K. Kawazoe, T. Oka, K. Ishibashi, H. Yamamoto, and F. Yamamoto Leaflet Suspension and Subvalvular Annuloplasty in Aortic Valve Prolapse Asian Cardiovasc Thorac Ann, June 1, 2009; 17(3): 278 - 281. [Abstract] [Full Text] [PDF]

				A. Vahanian, B. Iung, L. Piérard, R. Dion, and J. Pepper CHAPTER 21 Valvular Heart Disease ESC Textbook of Cardiovascular Medicine, January 1, 2009; 2(1): med-9780199566990-chapter - med-9780199566990-chapter. [Abstract] [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]

				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]

				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]

				J. A. Hawkins, P. C. Kouretas, R. Holubkov, R. V. Williams, L. Y. Tani, J. T. Su, L. M. Lambert, C. R. Mart, M. D. Puchalski, and L. L. Minich Intermediate-term results of repair for aortic, neoaortic, and truncal valve insufficiency in children J. Thorac. Cardiovasc. Surg., May 1, 2007; 133(5): 1311 - 1317. [Abstract] [Full Text] [PDF]

				M. A. Horberg, L. B. Hurley, D. B. Klein, S. E. Follansbee, C. Quesenberry, J. A. Flamm, G. M. Green, and T. Luu Surgical Outcomes in Human Immunodeficiency Virus-Infected Patients in the Era of Highly Active Antiretroviral Therapy Arch Surg, December 1, 2006; 141(12): 1238 - 1245. [Abstract] [Full Text] [PDF]

				H. Izumoto Aortic valve repair for aortic insufficiency in adults: a contemporary review and comparison with replacement techniques. Eur. J. Cardiothorac. Surg., May 1, 2006; 29(5): 854 - 854. [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]