Aortic Valve Repair: Initial Experience from Central Chest Hospital

Abstract

From September 1994 to September 1995, 24 patients underwent aortic valve repair in our hospital. It was successful in 21 cases and failed in the other 3 patients. There were 13 males and 8 females. The age range was between 20 and 60 years with a mean age of 35.6 years. Follow-up was complete in all patients. The mean follow-up time was 6.2 months, ranging from 3 weeks to 13 months. Aortic valve lesions in these patients were caused by rheumatic disease (17), endocarditis (2), congenital (1), and degenerative (1) conditions. The most common anatomic lesions were cusp thickening, cusp retraction, commissural fusion, and calcification. Most of the patients had other procedures along with aortic valve repair, including mitral valve repair (13), mitral valve replacement (3), tricuspid annuloplasty (2), and tricuspid repair (1). The most common surgical procedures were subcommissural annuloplasty, commissurotomy, cusp thinning, and free-edge unrolling. Cusp extension, using autologous pericardium was performed in 3 cases. Almost all of the patients needed multiple procedures (mean 3.4 procedures per patient). There was no hospital mortality nor valve-related complication in our series. No patient had a thromboembolic problem. Postoperative echocardiography showed an improvement in the mean aortic valve area and the pressure gradient across the aortic valve in patients with stenosis, and a decrease in the severity of aortic regurgitation in those with regurgitant lesions. We concluded that early results of aortic valve repair were encouraging and may be a good alternative treatment, especially in certain groups of patients.