Long Term Results of Aortic Valve Sparing Operations for Aortic Root Aneurysm
Back to 86th Annual Meeting
Back to Program Outline
Objective:
To examine the long-term results of aortic valve sparing (AVS) for aortic root aneurysm (ARA).
Methods:
Two hundred and twenty consecutive patients who had AVS for ARA were prospectively studied with annual clinical assessments and echocardiography. Their mean age was 47±16 years, 40% had Marfan syndrome, 12% had aortic dissection, and 6% had bicuspid aortic valve. Reimplantation of the aortic valve was performed in 151 patients and remodeling of the aortic root in 69. Associated aortic cusp repair was needed in 68 patients who had reimplantation and 5 who had remodeling. The mean follow-up was 5.2±3.5 years and 100% complete.
Results:
There were 4 operative and 15 late deaths. Three patients suffered a stroke and 7 transient ischemic attacks. Four patients required aortic valve replacement: 3 for aortic insufficiency (AI) and 1 for infective endocarditis. During the follow-up, 8 patients developed moderate and 3 severe AI. Remodeling of the aortic root was the only predictor of late AI (p=0.02). Table 1 shows the freedom from morbid events at various time intervals by the Kaplan-Meier method.
| Event | 1-year | 5-year | 10-year |
| Freedom from death | 97± 1% | 92±2% | 88±3% |
| Freedom from aortic valve replacement | 99± 0.5% | 97±1% | 93±3% |
| Freedom from endocarditis | 100% | 100% | 100% |
| Freedom from 3+ or 4+ AI: | | | |
| --- Remodeling | 100% | 96±2% | 56±17% |
| --- Reimplantation | 99±0.5% | 97±1% | 93±5% |
Conclusions: AVS is associated with low rates of valve-related complications. Reimplantation of the aortic valve is more durable than remodeling of the aortic root.
Back to 86th Annual Meeting
Back to Program Outline
