Aortic Valve Repair: Baku Experience

Abstract

Objective: Aortic valve repair could represent an alternative to valve replacement resulting in optimal hemodynamic conditions and avoiding anticoagulation. We analysed our results of aortic valve repair due to leaflets and root pathology. Methods: Between 2004-2019, we operated 74 patients with aortic valve and aortic root disease. Mean age was 49.2±14.7 years. 10 (13.5%) of them were females and 64 (86.5%) males. 18 (24.3%) patients were admitted with isolated aortic valve pathology. 15 (20.3%) patients had urgent operation for type A acute dissection, 14 (18.9%) aortic root aneurysm and 21 pts (28.4%) aortic root and ascending aortic aneurysm. All patients had peri-operative transesophageal echocardiography (TEE). We performed 18 (24.3%) isolated aortic valve repair operations, 38 (51.4%) reimplantation procedures, 16 (21.6%) remodeling procedures and 2 (2.7%) aortic valve repair and extraaortic ring implantation. The spectrum of valve repair techniques included free margin plication, subcomissural annuloplasty, resuspension, autologuos pericardial patch, leaflet replacement, neocomissura, decalsification, and comissurotomy. Results: Post-operative TEE showed trivial or grade I regurgitation for all patients. There were 2 (2.7%) in-hospital deaths (both had David procedure in acute Type A aortic dissection). Mean hospital stay was 8±4 days. Mean follow-up period was 49±11 months. In this period, we lost 1 patient (1.3%). Late echocardiography in the remaining 71 patients revealed mild aortic insufficiency in 66 patients (92.9%), moderate in 4 (5.6%), and moderate-severe in 1 patient (1.4%). Echocardiography confirmed the durability of the valve repair. Conclusions: Aortic valve repair operations, either as an isolated valve repair or in combination with surgery of the root, is an effective procedure with excellent mid-term and long-term outcomes without significant valve-related complications. KEYWORD: e-PD-49 The authors do not declare any conflict of interest.