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Valve sparing aortic root surgery via aortic root remoldeling with external root annuloplasty: prelimenary results in a single institution.

Author

Neil Christian P. Villamucho,
Nelson C. Lee,
Edgar S. Tuazon,
Marvin D. Martinez,
Anthony M. Manio

Related Institution

Adult Cardiology - Philippine Heart Center

Publication Information

Publication Type
Research Report
Date
January 1-December 31, 2015

Abstract

Background: Aortic root pathology can result in changes in the geometry of the sinutubular junction, sinuses, and the ventricular-aortic junction, leading to development of ascending aortic aneurysms, which may be distinct from aortic root disease producing aortic regurgitation, but may present as a combination of morphologic manifestations. Standard surgical procedure involved composite valve and graft replacement. This study was undertaken using Lansac' s aortic root remodeling with external root annuloplasty to preserve the native aortic valve of patients with aortic root aneurysms with or without dissection. We sought to describe the early outcomes of patients undergoing this procedure and whether the preservation of the aortic valve affected survival.


Methods: A total of 7 patients underwent valve sparing aortic root surgery via aortic root remodeling with external root annuloplasty. We reviewed the clinical material, operation methods, echocardiography check during operation and at discharge. Outcomes after the procedure were also documented.


Results: Seven patients underwent the procedure ( 6 male, 1 female), with a mean age of 40.714 ± 11.4 years. All patients presented with aortic root aneurysm with dissection. 1 patient underwent aortic valve replacement due to failure of repair. There were 2 morbidities reported, pneumothorax with subsequent thoracostomy and acute kidney injury which was managed medically, 1 patient was readmitted and eventually expired >30 days post op due to sepsis and Hospital acquired pneumonia.. 2DED prior to discharge showed no aortic regurgitation in 2 patients, 2 patients had mild AR, No 2D echocardiogram was done on 3 patients.


Conclusion: Preliminary results show that valve sparing aortic surgery via aortic root remodeling with external root annuloplasty is a viable alternative to aortic root replacement in our institution. More cases are needed to further validate the success of this procedure in our setting. Another important factor is postoperative care and follow up in order to document if there is improvement after repair.

Physical Location

LocationLocation CodeAvailable FormatAvailability
Philippine Heart Center Medical Library PHC.R.050.15 Fulltext Print Format

 
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