Aortic Valve Sparing Root Replacement in Tricuspid Valve Diseases
Saadallah TAMER, Stefano Mastrobuoni, Mona Momeni, David Vancraeynest, Jean Rubay, Gebrine Elkhoury, philippe Noirhomme, Laurent De Kerchove.
Cliniques Universitaires St-Luc, Woluwe-Saint-Lambert, Belgium.
To analyze our long-term experience with valve-sparing reimplantation technique in treating isolated root aneurysm, isolated aortic regurgitation, or both, as well as in aortic dissection. METHODS:
Between March 1998 and October 2018, 303 consecutive patients underwent valve-sparing reimplantation in our institution. The mean age of this cohort was 52.9±15 years. Time to event analysis was performed with the Kaplan-Meier method. RESULTS:
In-hospital mortality was 1% (n=3) of which 2 were admitted for acute aortic dissection. Two-hundred seventy-one patients were available for long-term analysis. Median follow-up was 5 years (IQR: 1.7-8.2). Thirty-nine patients (14.4%) died during follow-up setting survival at 10 years at 73+4.9%. Over the follow-up period, freedom from events like major bleeding, thromboembolic events and infective endocarditis at 10 years, were 96.7%, 97.5% and 96% respectively. Seventeen patients required late aortic valve reoperation and freedom from valve reoperation was therefore 89.6+2.9% at 10 years and was not significantly different between groups. CONCLUSIONS:
Our study shows that valve-sparing reimplantation is associated with low perioperative mortality, a remarkably low rate of valve-related complications and excellent long-term durability. Furthermore, we show that it can be equally performed in patients with severe isolated aortic regurgitation, and the durability of valve repair is similar regardless of the indication for surgery.
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