REVIEW  CURRENT RESULTS OF OPEN AND MINIMALLY INVASIVE AORTIC VALVE REPAIR 

The Journal of Cardiovascular Surgery 2021 February;62(1):12-8

DOI: 10.23736/S0021-9509.20.11690-2

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Root repair with aortic ring annuloplasty using the standard approach

Pouya YOUSSEFI ¹, Pavel ZACEK ², Alain BERREBI ¹, Daniel CZYTROM ¹, Leila MANKOUBI ¹, Milena NOGHIN ¹, Jean Luc MONIN ¹, Mathieu DEBAUCHEZ ¹, Emmanuel LANSAC ¹ ✉

¹ Department of Cardiac Surgery, Institut Mutualiste Montsouris, Paris, France; ² Department of Cardiac Surgery, Hradec Kralove, Czech Republic

Standardization of aortic valve repair techniques with use of a calibrated annuloplasty have led to improved long-term outcomes in dystrophic aortic insufficiency. It can also improve dissemination of techniques and rates of aortic valve repair. Dystrophic aortic insufficiency can be found in three aortic phenotypes: dilated aortic root, dilated ascending aorta and isolated aortic insufficiency. The aortic annulus is invariably dilated above 25 mm in the vast majority of cases of aortic insufficiency, regardless of whether the aorta is dilated or not. A dilated annulus is a risk factor for late failure of aortic valve repair if not addressed at the time of surgery. We perform a calibrated annuloplasty at both sub- and supra-valvular levels in order to restore the ratio of sinotubular junction and annulus. Current evidence shows aortic valve repair reduces valve-related mortality compared to prosthetic valve replacement, with an improved quality of life.

KEY WORDS: Aortic valve insufficiency; Aneurysm; Bicuspid; Cardiac valve annuloplasty