Scripties UMCG - Rijksuniversiteit Groningen
English | Nederlands

The results of aortic valve repair procedures for aortic regurgitation

(2016) Wit, A.E. de

Background: Valve-preserving surgery of the aortic valve has become a standard approach in the treatment of aortic root aneurysm and aortic regurgitation (AR). By avoiding lifelong anticoagulation therapy it offers a good alternative for the composite graft replacement. Recently there is a renewed interest in this valve-preserving surgery, but due to limited experience with this procedure in the Netherlands, it is only performed in a small number of expertise centers.
Objectives: This study was performed to gain more data on valve-preserving surgery in one of these expertise centers in the Netherlands, the Thorax Centrum Twente (TCT) in Enschede. We studied the outcome of the aortic valve repair procedures looking at incidence of recurrent AR and valve-related complications, reduction of symptoms of AR and mortality rate. Outcome was compared with existing results of valve-preserving surgery.
Methods: Over a 4-year period, 69 consecutive patients underwent valve-preserving surgery in the TCT. In this retrospective cohort study, clinical and echocardiographic data were collected from medical records. Follow-up was complete in 100% (cumulative follow-up: 123 patient-years). Results: Overall freedom from relevant recurrent AR (≥ grade II) at 12, 24, 36 and 48 months after surgery was 92%, 87%, 83% and 66% respectively. Freedom from valve-related complications at 1 and 4 years after surgery was 91% and 89% respectively. There was a significant reduction in preoperative symptoms 3 months after the surgery (p < 0.001). The 30-day mortality rate was 2,9%. There were no late deaths.
Conclusions: Aortic valve repair procedures in the TCT are performed with low morbidity and mortality in patients with AR and aortic root aneurysm. Valve-preserving surgery is performed safely in the TCT and with acceptable early and mid-term outcomes.

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