EP07 AORTIC VALVE REPAIR TECHNIQUES: AN EARLY EXPERIENCE FROM A SINGLE UK CENTRE

Abstract

Background and aim: Aortic valve repair (AVr) is an evolving area with only few European centres reporting a large volume experience. Very few other surgical units have adopted this approach, even in patients with pure aortic regurgitation (AR). Our aim is to report our early experience with AVr techniques. Method: 59 patients with a mean age of 49 years (range 19–85) underwent AVr for either primary (cusp prolapse or perforation) or secondary (aortic root and/or ascending aneurysms) AR. 14 patients had a bicuspid aortic valve. Standard repair techniques were used including: sub-commissural annuloplasty, STJ remodelling, free-edge plication, commissural resuspension, raphe resection, free-edge reinforcement and VSRR. Results: All patients underwent successful AVr including 1 patient who required a 2nd pump run. The post-bypass TOE demonstrated no/trace AR in 49 (83%) cases, mild central AR in 8 (13.6%) and mild eccentric AR in only 2 (3.4%) cases. 30 day survival was 100%. 2 patients suffered post-operative strokes, none required PPM insertion. At a mean clinical follow-up of 4.7 ± 2.7 years all patients are alive and well. Echo follow-up (2.3 ± 1.9 y) showed: no or trace AR in 25 patients (42.4%), mild AR in 22 patients (37.3%), moderate AR in 11 patients (18.6%), severe AR in 1 patient (1.7%), who underwent re-do AVR 5 years after VSRR. Freedom from re-operation was 87% at 8 years. Conclusion: Despite achieving an excellent immediate (post-bypass) technical result, we remain cautious about the long-term durability of AVr procedures. We therefore continue to carefully evaluate AVr in our practice.