Aortic Valve Sparing in 120 Patients with Aortic Root Aneurysms

Introduction and objectives: Several aortic valve sparing techniques have been described for the treatment of aortic root aneurysms. We report our experience using the reimplantation technique in 120 patients.Methods: Between March 2004 and October 2010, 120 patients with aortic root aneurysms underwent David operations. Of these, 51 were diagnosed with Marfan syndrome. Mean patient age was 31 +/- 12 years. The mean diameter of the sinuses of Valsalva was 51 +/- 5 mm and moderate/severe aortic regurgitation was present in 16% of these patients. In the other 69 patients mean age was 56 +/- 14 years, the mean diameter of the sinuses of Valsalva was 53 +/- 7 mm and moderate/severe aortic regurgitation was present in 66%. A bicuspid aortic valve was presented in 14 cases.Results: Hospital mortality was 1.7%. Mean follow-up was 37 +/- 21 months; 94% of the patients survived and 96% had an aortic regurgitation below grade II during 5 years of follow-up. One patient required re-operation because of severe aortic regurgitation. No endocarditis or thromboembolic complications have been documented, and 96% of the patients did not receive any anticoagulation therapy.Conclusions: Short- and mid-term results with the reimplantation technique for aortic root aneurysms are excellent. This technique prevents the need for chronic anticoagulation treatment as well as the complications arising from mechanical prostheses, and it should be the treatment of choice for young patients. (C) 2011 Sociedad Espanola de Cardiologia. Published by Elsevier Espana, S.L. All rights reserved.