Current controversies in aortic valve-preserving surgery

Kunihara, Takashi

doi:10.1016/j.jjcc.2022.10.006

Cited by 2 publications

(2 citation statements)

References 154 publications

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“…It also carries prognostic value both in terms of valve repairability and of long-term outcomes: Type III AR is associated with poorer long-term outcomes after valve sparing surgery and a higher risk of recurrent AR post valve repair [ 23 – 25 ]. Cusp perforation/fenestration is another important phenotype that has important implications for the choice of surgical treatment, as it has less favourable outcomes when treated with valve repair [ 25 , 26 ].…”

Section: Echocardiographic Assessment Of Aortic Regurgitationmentioning

confidence: 99%

Echocardiographic assessment of aortic regurgitation: a narrative review

Tsampasian,

Victor,

Bhattacharyya

et al. 2024

Echo Res Pract

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Aortic regurgitation (AR) is the third most frequently encountered valve lesion and may be caused by abnormalities of the valve cusps or the aorta. Echocardiography is instrumental in the assessment of AR as it enables the delineation of valvular morphology, the mechanism of the lesion and the grading of severity. Severe AR has a major impact on the myocardium and carries a significant risk of morbidity and mortality if left untreated. Established and novel echocardiographic methods, such as global longitudinal strain and three-dimensional echocardiography, allow an estimation of this risk and provide invaluable information for patient management and prognosis. This narrative review summarises the epidemiology of AR, reviews current practices and recommendations with regards to the echocardiographic assessment of AR and outlines novel echocardiographic tools that may prove beneficial in patient assessment and management.

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Section: Echocardiographic Assessment Of Aortic Regurgitationmentioning

confidence: 99%

Echocardiographic assessment of aortic regurgitation: a narrative review

Tsampasian,

Victor,

Bhattacharyya

et al. 2024

Echo Res Pract

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“…Aortic valve (AV) repair is a treatment option for aortic regurgitation (AR) in cases with no or mild cusp degeneration. This procedure employs various techniques, such as annuloplasty, repair with pericardium, and cusp plication, each tailored to the AR etiology in individual cases [ 1 ]. AV repair is particularly appealing for younger AR patients who would otherwise require a mechanical valve for aortic valve replacement (AVR), as it allows them to discontinue anticoagulant therapy after surgery.…”

Section: Introductionmentioning

confidence: 99%

Mid-Term Outcomes of Aortic Valve Repair Without Aortic Root Replacement: A Single-Center Experience

Kato,

Nishioka,

Yamamoto

et al. 2024

Cureus

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Background Aortic valve (AV) repair is a challenging procedure due to its complexity, lower reproducibility, and steep learning curve. To examine its durability and validity, we investigated mid-term outcomes following AV repair without aortic root replacement. Methods Between March 2007 and May 2018, we retrospectively identified 14 patients who underwent AV repair without aortic root replacement at our institution. We investigated their baseline characteristics and postoperative outcomes, including the reoperation rate due to aortic regurgitation (AR) recurrence. Furthermore, we divided them into two groups: those who required reoperation due to AR recurrence (Group R) and those who did not require reoperation (Group F), and statistically compared them. Results The median age was 52.5 years (IQR: 42.0-60.8), with 11 male patients (78.6%). Eight patients (57.1%) had a bicuspid AV. Five cases (35.7%) underwent reoperation due to AR recurrence during a median follow-up period of 5.5 years. There were no significant differences in baseline characteristics between Group R (n=5, 35.7%) and Group F (n=9, 64.3%), including AR etiology, AV repair procedure, and intraoperative AR grade after the final declamp. All cases in Group R had at least mild to moderate AR on the echocardiogram before discharge. Regarding the AR grade before discharge, Group R had a significantly higher grade than Group F (p = 0.013). Conclusions The indication for AV repair for AR might need to be reassessed due to the considerable mid-term reoperation rate. Cases of AV repair with more than mild AR at discharge should be carefully monitored, as they are likely to require future reoperation for AR.

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Current controversies in aortic valve-preserving surgery

Cited by 2 publications

References 154 publications

Echocardiographic assessment of aortic regurgitation: a narrative review

Echocardiographic assessment of aortic regurgitation: a narrative review

Mid-Term Outcomes of Aortic Valve Repair Without Aortic Root Replacement: A Single-Center Experience

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