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 Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by El Khoury, G. Articles by Noirhomme, Ph. Search for Related Content PubMed PubMed Citation Articles by El Khoury, G. Articles by Noirhomme, Ph. Related Collections Cardiac - other Great vessels Valve disease

Eur J Cardiothorac Surg 2004;26:628-633
© 2004 Elsevier Science NL

Repair of aortic valve prolapse: experience with 44 patients

^a Departments of Cardiovascular and Thoracic Surgery, Cardiology, Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, Brussels 1200, Belgium
^b Public Health School, Université Catholique de Louvain, Brussels, Belgium

Received 20 October 2003; received in revised form 30 April 2004; accepted 18 May 2004.

^* Corresponding author. Address: Service de Chirurgie Cardiovasculaire et Thoracique, Cliniques Universitaires Saint-Luc UCL 90, Avenue Hippocrate 10, Brussels B-1200, Belgium. Tel.: +32-2-764-6106; fax: +32-2-764-8960
e-mail: elkhoury{at}chir.ucl.ac.be

Objectives: In regurgitant tricuspid aortic valves, cusp prolapse may be isolated or associated with dilatation of the proximal aorta. Newly appearing cusp prolapse can also appear after an aortic valve sparing operation (AVSO) and be responsible for residual aortic regurgitation. In this report, we describe our experience in repairing prolapsing aortic cusps in 44 patients with aortic regurgitation. Methods: Between 1996 and 2003, 260 patients had aortic valve repair or valve sparing procedures in our department. All patients had peri-operative TEE. Prolapse of one or more of the aortic cusps was identified by TEE and confirmed by careful surgical inspection before and after valve sparing surgery. Forty-four patients with cusp prolapse were identified. Fifteen had an isolated prolapse, with a normal root (group I), 18 had cusp prolapse associated with dilatation of the proximal aorta (group IIa), and 11 had a newly appearing prolapse after AVSO (group IIb). Correction of the prolapsing cusp was achieved by either free edge plication, triangular resection or resuspension with PTFE. This procedure was associated with an aortic annuloplasty in group I, and with AVSO in groups II and III. Results: Post-operative TEE showed AR trivial or grade I regurgitation. At a mean of 23 months follow-up, one patient with recurrent regurgitation required an aortic valve replacement with a homograft. All remaining patients were in NYHA class I or II. Echocardiography confirmed the durability of the valve repair. Conclusions: Among the common causes of aortic regurgitation, isolated cusp prolapse is frequent and is amenable to surgical repair with excellent mid-term results. In particular, in patents who are potential candidates for AVSO, identification and correction of an associated prolapse, either pre-existing or secondary to the AVSO procedure, may further extend the indications for this technique, increase its success rates and improve its long-term outcome.

Key Words: Tricuspid aortic valve prolapse • Aortic insufficiency • Aortic valve repair

This article has been cited by other articles:

				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]

				E. Lansac, I. Di Centa, F. Raoux, N. A. Attar, C. Acar, T. Joudinaud, and R. Raffoul A lesional classification to standardize surgical management of aortic insufficiency towards valve repair Eur. J. Cardiothorac. Surg., May 1, 2008; 33(5): 872 - 878. [Abstract] [Full Text] [PDF]

				A. Kadner, O. Raisky, A. Degandt, D. Tamisier, D. Bonnet, D. Sidi, and P. R. Vouhe The Ross Procedure in Infants and Young Children Ann. Thorac. Surg., March 1, 2008; 85(3): 803 - 808. [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]

				H. Dave and R. Pretre Pericardial patch reconstruction of the congenitally diseased aortic valve MMCTS, May 7, 2007; 2007(0507): 1354. [Abstract] [Full Text] [PDF]

				H. Jeanmart, L. de Kerchove, D. Glineur, J.-M. Goffinet, I. Rougui, M. Van Dyck, P. Noirhomme, and G. El Khoury Aortic Valve Repair: The Functional Approach to Leaflet Prolapse and Valve-Sparing Surgery Ann. Thorac. Surg., February 1, 2007; 83(2): S746 - S751. [Abstract] [Full Text] [PDF]

				B. Chiappini, A.-C. Pouleur, P. Noirhomme, J.-C. Funken, P. Astarci, R. Verhelst, A. Poncelet, and G. ElKhoury Repair of trileaflet aortic valve prolapse: mid-term outcome in patients with normal aortic root morphology Interactive CardioVascular and Thoracic Surgery, February 1, 2007; 6(1): 56 - 59. [Abstract] [Full Text] [PDF]

				H. F. Lausberg, D. Aicher, F. Langer, and H.-J. Schafers Aortic valve repair with autologous pericardial patch. Eur. J. Cardiothorac. Surg., August 1, 2006; 30(2): 244 - 249. [Abstract] [Full Text] [PDF]

				R. Pretre, A. Kadner, H. Dave, D. Bettex, and M. Genoni Tricuspidisation of the aortic valve with creation of a crown-like annulus is able to restore a normal valve function in bicuspid aortic valves. Eur. J. Cardiothorac. Surg., June 1, 2006; 29(6): 1001 - 1006. [Abstract] [Full Text] [PDF]

				R. Di Bartolomeo, D. Pacini, S. Martin-Suarez, A. Loforte, A. Dell'Amore, M. Ferlito, G. Bracchetti, and G. Bozzetti Valsalva prosthesis in aortic valve-sparing operations Interactive CardioVascular and Thoracic Surgery, June 1, 2006; 5(3): 294 - 298. [Abstract] [Full Text] [PDF]

				F. Settepani, D. Ornaghi, A. Barbone, E. Citterio, A. Eusebio, E. Manasse, G. Silvaggio, and R. Gallotti Aortic valve-sparing operations in patients with aneurysms of the aortic root or ascending aorta: preliminary results Interactive CardioVascular and Thoracic Surgery, April 1, 2005; 4(2): 137 - 139. [Abstract] [Full Text] [PDF]