Novel technique of aortic valvuloplasty.

OBJECTIVE The present study was aimed to assess the results of newly developed aortic valve repair technique. METHODS Between 1997 and 2004, 69 aortic valvuloplasties were performed with a new technique addressing the three main components of the aortic root; leaflets (L), sinotubular junction (STJ), and aortic annulus (A). For leaflet correction, additional leaflets were implanted and for STJ and annular reduction, an internal synthetic ring and strip along the fibrous annulus were implanted, respectively. The patients were divided into two groups: 30 patients with isolated aortic regurgitation (group IAR) were treated by correction of STJ+L (n=21) and STJ+A+L (n=9), and 39 aortic regurgitation patients with annuloaortic ectasia or ascending aortic aneurysm (group AAR) were treated with STJ correction only (n=16), STJ+A (n=6), STJ+L (n=9), and STJ+A+L (n=8). RESULTS The mean age was 43.4 and 49.5 years for groups IAR and AAR, respectively. There was neither operative nor follow-up death in either group. Suture breakage caused one reoperation in group IAR. Mean follow-up was 13.8 and 20.3 months in groups IAR and AAR, respectively. The preoperative aortic regurgitation grade was 3.67 in group IAR and 2.67 in group AAR. The last follow-up aortic regurgitation grade was 1.1 in group IAR and 1.05 in group AAR. No patient, except for the reoperated patient had AR greater than grade 2. The postoperative pressure gradient was 19.3 mmHg in group IAR and 8. 4mmHg in group AAR. CONCLUSIONS The results showed this technique to be safe and effective. Thus far broad application of this repair technique has been demonstrated to be highly feasible.