University of Sussex
Browse

File(s) not publicly available

Factors associated with the development of aortic valve regurgitation over time after two different techniques of valve-sparing aortic root surgery

journal contribution
posted on 2023-06-08, 00:24 authored by Thorsten Hanke, Efstratios I Charitos, Ulrich Stierle, Derek Robinson, Armin Gorski, Hans-H Sievers, Martin Misfeld
Objective Early results after aortic valve-sparing root reconstruction are excellent. Longer-term follow-up, especially with regard to aortic valve function, is required for further judgment of these techniques. Methods Between July of 1993 and September of 2006, 108 consecutive patients (mean age 53.0 ± 15.8 years) underwent the Yacoub operation (group Y) and 83 patients underwent the David operation (group D). Innovative multilevel hierarchic modeling methods were used to analyze aortic regurgitation over time. Results In general, aortic regurgitation increased with time in both groups. Factors associated with the development of a significant increase in aortic regurgitation were Marfan syndrome, concomitant cusp intervention, and preoperative aortic anulus dimension. In Marfan syndrome, the initial aortic regurgitation was higher in group Y versus group D (0.56 aortic regurgitation vs 0.29 aortic regurgitation, P = .049), whereas the mean annual progression rate of aortic regurgitation was marginally higher in group Y (0.132 aortic regurgitation vs 0.075 aortic regurgitation, P = .1). Concomitant cusp intervention was associated with a significant aortic regurgitation increase in both groups (P < .0001). There was a trend that smaller preoperative aortic annulus diameters in group D and larger diameters in group Y were associated with increased aortic regurgitation over time. Conclusion In regard to aortic regurgitation grade over time, patients with Marfan syndrome and a large preoperative aortic annulus diameter were better treated with the reimplantation technique, whereas those with a smaller diameter were better treated with the remodeling technique. Concomitant free-edge plication of prolapsing cusps was disadvantageous in both groups. Considering these factors may serve to improve the aortic valve longevity after valve-sparing aortic root surgery.

History

Publication status

  • Published

Journal

Journal of Thoracic and Cardiovascular Surgery

ISSN

0022-5223

Publisher

Elsevier

Issue

2

Volume

137

Page range

314-319

Pages

6.0

Department affiliated with

  • Mathematics Publications

Full text available

  • No

Peer reviewed?

  • Yes

Legacy Posted Date

2012-02-06

Usage metrics

    University of Sussex (Publications)

    Categories

    No categories selected

    Exports

    RefWorks
    BibTeX
    Ref. manager
    Endnote
    DataCite
    NLM
    DC