The role of neo‐sinus reconstruction in aortic valve‐sparing surgery. Issue 6 (8th May 2017)

• Record Type: Journal Article
• Authors: Gaudino, Mario; Di Franco, Antonino; Weltert, Luca; Benedetto, Umberto; Lau, Christopher; Gambardella, Ivancarmine; De Paulis, Ruggero; Girardi, Leonard N.
• Is Part Of: Journal of cardiac surgery. Volume 32:Issue 6(2017)
• Page Start: 328
• Page End: 333
• Publication Date: 2017-05-08
• Subjects: David procedure -- Valsalva sinuses -- valve‐sparing aortic surgery; Heart -- Surgery -- Periodicals; 617.412005
• DOI: 10.1111/jocs.13143
• Languages: English
• ISSNs: 0886-0440

Abstract

Abstract: Aims: The aim of this study was to evaluate the clinical and echocardiographic results and the predictors of outcomes in patients undergoing valve‐sparing operation (VSO) at two aortic centers. In addition, we sought to evaluate the potential effect of recreation of the sinuses of Valsalva (SV) on the outcome of valve‐sparing procedures. Methods: During a 14‐year period, 328 patients underwent aortic valve‐sparing root replacement at two institutions. Clinical and echo evaluation was performed 6 months after surgery and every year thereafter or in case of clinical symptoms. Propensity weighting and propensity‐weighted risk competing analysis were used. Results: No operative mortality was reported; the most common complication was revision for bleeding, occurring in 15 patients (4.6%). At a mean follow‐up of 30.0 ± 33.9 months, two patients died (0.6%). Recurrent aortic insufficiency (AI) >2+ was found in 11 patients (3.3%); five (1.5%) underwent reoperation. Recreation of the SV did not affect clinical outcome and aortic valve status. Need for aortic valve repair was the only independent predictor of recurrent AI, whereas a bicuspid aortic valve was a protective factor. Conclusions: Re‐creation of the SV does not affect short‐term outcomes following VSO.