Aortic root stability in bicuspid aortic valve disease patch augmentation plus reduction aortoplasty versus modified David type repair

被引:15
作者
Doss, Mirko [1 ]
Risteski, Petar [1 ]
Sirat, Sami [1 ]
Bakhtiary, Farhad [1 ]
Martens, Sven [1 ]
Moritz, Anton [1 ]
机构
[1] Goethe Univ Frankfurt, Dept Thorac & Cardiovasc Surg, D-60590 Frankfurt, Germany
关键词
Aortic valve repair; Autologous pericardium; Aortic root; ASCENDING AORTA; REPLACEMENT; RECONSTRUCTION;
D O I
10.1016/j.ejcts.2010.03.006
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objectives The unreinforced aortic root, in bicuspid aortic valve disease, has been shown to dilate and cause recurrent regurgitation The objective of this study was to determine whether reduction aortoplasty can reliably prevent aortic root dilatation after aortic valve repair in bicuspid disease Methods A total of 66 patients, with a mean age of 41 2 +/- 12 years and with incompetent bicuspid aortic valves and concomitant dilatation of the aortic root, were included in this study As many as 49 patients had patch augmentation of the free edge of the bicuspid aortic leaflets and reduction aortoplasty, and a further 17 patients had patch augmentation and a modified David type repair Patients were followed up by echocardiography and clinically in yearly intervals Results At midterm (mean follow up was 5 1 +/- 2 1 years) only one patient in the reduction aortoplasty group showed aortic root dilatation, leading to significant aortic valve regurgitation Other than that, there was no progression of regurgitation in the whole group of patients In the David type repair group, no re operations, progression of aortic root dilatation or recurrent regurgitation occurred In general, there was only one death in the reduction aortoplasty group This patient developed endocarditis after 1 year and died of acute heart failure prior to readmission to our hospital Conclusion Both reduction aortoplasty and modified David type repair, paired with patch augmentation of the incompetent bicuspid valve provide excellent midterm results The reduction of the diameter of the ascending aorta by reduction aortoplasty seems to provide reliable stability that is comparable to the David type repair (C) 2010 European Association for Cardio Thoracic Surgery Published by Elsevier B V All rights reserved
引用
收藏
页码:523 / 527
页数:5
相关论文
共 14 条
[1]   Reduction aortoplasty for dilatation of the ascending aorta in patients with bicuspid aortic valve [J].
Bauer, M ;
Pasic, M ;
Schaffarzyk, R ;
Siniawski, H ;
Knollmann, F ;
Meyer, R ;
Hetzer, R .
ANNALS OF THORACIC SURGERY, 2002, 73 (03) :720-723
[2]   A TECHNIQUE FOR COMPLETE REPLACEMENT OF ASCENDING AORTA [J].
BENTALL, H ;
DEBONO, A .
THORAX, 1968, 23 (04) :338-&
[3]   Should the ascending aorta be replaced more frequently in patients with bicuspid aortic valve disease? [J].
Borger, MA ;
Preston, M ;
Ivanov, J ;
Fedak, FWM ;
Davierwala, P ;
Armstrong, S ;
David, TE .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2004, 128 (05) :677-683
[4]   Intermediate-term durability of bicuspid aortic valve repair for prolapsing leaflet [J].
Casselman, FP ;
Gillinov, AM ;
Akhrass, R ;
Kasirajana, V ;
Blackstone, EH ;
Cosgrove, DM .
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 1999, 15 (03) :302-308
[5]  
DAVID TE, 1992, J THORAC CARDIOV SUR, V103, P617
[6]   Pericardial patch augmentation for reconstruction of incompetent bicuspid aortic valves [J].
Doss, M ;
Moid, R ;
Wood, JP ;
Miskovic, A ;
Martens, S ;
Moritz, A .
ANNALS OF THORACIC SURGERY, 2005, 80 (01) :304-308
[7]   AORTIC-VALVE REPLACEMENT WITH FREEHAND AUTOLOGOUS PERICARDIUM [J].
DURAN, CMG ;
GOMETZA, B ;
KUMAR, N ;
GALLO, R ;
MARTINDURAN, R .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 1995, 110 (02) :511-516
[8]   Long-term survival after the Bentall procedure in 206 patients with bicuspid aortic valve [J].
Etz, Christian D. ;
Homann, Tobias M. ;
Silovitz, Daniel ;
Spielvogel, David ;
Bodian, Carol A. ;
Luehr, Maximilian ;
DiLuozzo, Gabriele ;
Plestis, Konstadinos A. ;
Griepp, Randall B. .
ANNALS OF THORACIC SURGERY, 2007, 84 (04) :1186-1194
[9]   REPAIR OF INSUFFICIENT BICUSPID AORTIC VALVES [J].
FRASER, CD ;
WANG, N ;
MEE, RBB ;
LYTLE, BW ;
MCCARTHY, PM ;
SAPP, SK ;
ROSENKRANZ, ER ;
COSGROVE, DM .
ANNALS OF THORACIC SURGERY, 1994, 58 (02) :386-390
[10]   Aortic cusp extension valvuloplasty for rheumatic aortic valve disease: Midterm results [J].
Grinda, JM ;
Latremouille, C ;
Berrebi, AJ ;
Zegdi, R ;
Chauvaud, S ;
Carpentier, AF ;
Fabiani, JN ;
Deloche, A .
ANNALS OF THORACIC SURGERY, 2002, 74 (02) :438-443