Abstract

A Review of Surgical Aortic Valve Repair. Indications and techniques for the General Cardiologist

Highlights

  • Young patients, those employed in high-risk occupations such as the military or among competitive athletes, who have aortic valve pathology, present a well-documented challenge in the current era

  • Of the indices of cusp geometry, Schäfers et al [24] determined that the distance between the basal plane and central free margin is 8-10 mm in the normal aortic valve when measured in diastole; this measurement is termed the Effective Height

  • Jasinski et al [45] report their experience with AV repair for aortic regurgitation for 200 consecutive cases involving either tricuspid or bicuspid aortic valves over a 10-year period

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Summary

Introduction

Those employed in high-risk occupations such as the military or among competitive athletes, who have aortic valve pathology, present a well-documented challenge in the current era. In a report from the Society of Thoracic Surgeons database [8], it was determined that there is an increasing trend towards AVR using biostented valves, while AV repair remains an uncommon procedure for most surgical centers. According to this same report, currently only 5% of institutions participating in the Society of Thoracic Surgeons Adult Cardiac Surgery database (STS ACSD) performed >16 aortic valve sparing procedures in 2009. We review how advanced, non-invasive imaging is currently helping improve surgical planning and outcomes

Anatomy of the aortic root
Surgical technique
The Effective Height Concept
Leaflet Repair
Surgical Repair of the bicuspid valve
Unicuspid valve
Echocardiographic guided surgical planning
Findings
Conclusion

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