Cirugía reparadora de la insuficiencia aórtica

Abstract

IntroductionWe present our initial experience with isolated aortic valve repair or remodeling operation (Yacoub) in patients with aortic root dilatation. Short and mid-term follow-up data are reported. MethodsFrom 2009 to 2011, 25 patients underwent surgery. Yacoub remodeling surgery was carried out in 9 cases with root dilatation: anuloaortic ectasia in 8 cases, Beals Syndrome in one case. Coroneo® ring was implanted in 6 of these and subaortic Schäfers suture in 3. In the 16 cases isolated valve insufficency was the only pathology found (4 bicuspid cases). Echocardiogram was also carried out in the immediate postoperative period as well as one, six, 12 and 24 months after surgery. ResultsHospital mortality was 4% (1/25). Mean age was 44. Mean ischemic time was 54minutes for isolated valve repair and 139minutes for aortic root remodeling. Two patients were reoperated upon due to severe aortic regurgitation. Control echocardiograms showed satisfactory repair in 21 cases with minimum residual insufficiency and moderate regurgitation in 2 cases. ConclusionsOur technique of choice for aortic valve repair is the central plication being an intuitive and reproducible technique. In aortic regurgitation associated with aortic root dilatation the technique of choice is the Yacoub remodeling with Coroneo® ring, providing lasting annular support.