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Eur J Cardiothorac Surg 2006;29:530-536
© 2006 Elsevier Science NL

Novel technique of aortic valvuloplasty

^a Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan, Seoul, Republic of Korea
^b Department of Radiology, Asan Medical Center, University of Ulsan, Seoul, Republic of Korea
^c Division of Cardiology, Asan Medical Center, University of Ulsan, Seoul, Republic of Korea
^d Department of Thoracic and Cardiovascular Surgery, Ulsan University Hospital, University of Ulsan, Ulsan, Republic of Korea

Received 21 September 2005; received in revised form 27 December 2005; accepted 6 January 2006.

^_* Corresponding author. Address: 388-1 Pungnap-2dong, Songpa-gu, Seoul 138-736, Republic of Korea. Tel.: +82 2 3010 3580; fax: +82 2 3010 6966. (Email: mgsong{at}amc.seoul.kr).

Objective: The present study was aimed to assess the results of newly developed aortic valve repair technique. Methods: Between 1997 and 2004, 69 aortic valvuloplasties were performed with a new technique addressing the three main components of the aortic root; leaflets (L), sinotubular junction (STJ), and aortic annulus (A). For leaflet correction, additional leaflets were implanted and for STJ and annular reduction, an internal synthetic ring and strip along the fibrous annulus were implanted, respectively. The patients were divided into two groups: 30 patients with isolated aortic regurgitation (group IAR) were treated by correction of STJ + L (n = 21) and STJ + A + L (n = 9), and 39 aortic regurgitation patients with annuloaortic ectasia or ascending aortic aneurysm (group AAR) were treated with STJ correction only (n = 16), STJ + A (n = 6), STJ + L (n = 9), and STJ + A + L (n = 8). Results: The mean age was 43.4 and 49.5 years for groups IAR and AAR, respectively. There was neither operative nor follow-up death in either group. Suture breakage caused one reoperation in group IAR. Mean follow-up was 13.8 and 20.3 months in groups IAR and AAR, respectively. The preoperative aortic regurgitation grade was 3.67 in group IAR and 2.67 in group AAR. The last follow-up aortic regurgitation grade was 1.1 in group IAR and 1.05 in group AAR. No patient, except for the reoperated patient had AR greater than grade 2. The postoperative pressure gradient was 19.3 mmHg in group IAR and 8.4 mmHg in group AAR. Conclusions: The results showed this technique to be safe and effective. Thus far broad application of this repair technique has been demonstrated to be highly feasible.

Key Words: Aortic valve • Aortic root • Aortic regurgitation • Marfan's syndrome

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