Functional annulus remodelling using a prosthetic ring in tricuspid aortic valve repair: mid-term results

被引:7
|
作者
Fattouch, Khalil [1 ]
Castrovinci, Sebastiano [2 ]
Murana, Giacomo [2 ]
Nasso, Giuseppe [3 ]
Guccione, Francesco [1 ]
Dioguardi, Pietro [1 ]
Salardino, Massimo [4 ]
Bianco, Giuseppe [1 ]
Speziale, Giuseppe [3 ]
机构
[1] Maria Eleonora Hosp, GVM Care & Res, Dept Cardiovasc Surg, I-90100 Palermo, Italy
[2] Univ Bologna, Dept Cardiac Surg, Bologna, Italy
[3] Anthea Hosp, GVM Care & Res, Dept Cardiovasc Surg, Bari, Italy
[4] Maria Beatrice Hosp, GVM Care & Res, Dept Cardiovasc Surg, Florence, Italy
关键词
Aortic valve; Repair; Statistics; Risk analysis; Echocardiography; SPARING OPERATION; CLASSIFICATION; INSUFFICIENCY; IMPLANTATION; ANEURYSM; LEAFLET;
D O I
10.1093/icvts/ivt410
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVES: The functional aortic valve annulus (FAVA) is a complex unit with proximal (aorto-ventricular junction) and distal (sinotubular junction) components. The aim of our study was to evaluate the impact of the total FAVA remodelling, using a prosthetic ring, on mid-term clinical and echocardiographic results after aortic valve repair. METHODS: Since February 2003, 250 patients with tricuspid aortic valve insufficiency (AI) underwent aortic valve repair. FAVA dilatation was treated by prosthetic ring in 52 patients, by isolated subcommissural plasty in 62, by subcommissural plasty plus ascending aortic replacement in 57 and by David's reimplantation procedure in 79. Survival rate and freedom from recurrent AI greater than or equal to moderate were evaluated by Kaplan-Meier. RESULTS: Overall late survival was 90.4%. Late cardiac-related deaths occurred in 15 patients. At follow-up, 36 (16%) patients had recurrent AI greater than or equal to moderate because of cusp reprolapse and/or FAVA redilatation. Freedom from recurrent AI was significantly higher for patients who underwent David's procedure or FAVA remodelling by prosthetic ring than those who underwent isolated subcommissural plasty (P < 0.01) or subcommissural plasty plus ascending aortic replacement (P = 0.02). There was no statistical difference between David's procedure and prosthetic ring annuloplasty (P = 0.26). CONCLUSION: FAVA remodelling using a prosthetic ring is a safe procedure in aortic valve repair surgery thanks to long-term annulus stabilization and it is a pliable alternative to David's procedure in selected patients. This technique may be used in all patients with slight root dilatation to avoid aggressive root reimplantation. We also recommended total FAVA annuloplasty in all patients who underwent aortic valve repair to improve long-term repair results.
引用
收藏
页码:49 / 54
页数:6
相关论文
共 50 条
  • [1] Functional annulus remodelling using a prosthetic ring in tricuspid aortic valve repair: mid-term results CONFERENCE DISCUSSION
    Lansac, E.
    Fattouch
    Mostafa, E.
    [J]. INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY, 2014, 18 (01) : 54 - 55
  • [2] Tricuspid valve repair with a three-dimensional design ring: Mid-term results
    Monguio, Emilio
    Castano, Beatriz
    de la Rosa, Cristina
    Perez Serradilla, Ana
    Buendia, Jose A.
    Maicas, Carolina
    Lopez Almodovar, Luis F.
    Alcala, Juan E.
    Lima, Pedro
    Canas, Alfonso
    [J]. CIRUGIA CARDIOVASCULAR, 2013, 20 (04): : 188 - 193
  • [3] Mid-Term Results of Tricuspid Annuloplasty with a Three-Dimensional Remodelling Ring
    De Bonis, Michele
    Lapenna, Elisabetta
    Taramasso, Maurizio
    Manca, Mario
    Calabrese, Maria Chiara
    Buzzatti, Nicola
    Rossodivita, Alessandra
    Pappalardo, Federico
    Dorigo, Enrica
    Alfieri, Ottavio
    [J]. JOURNAL OF CARDIAC SURGERY, 2012, 27 (03) : 288 - 294
  • [4] Valve repair to avoid prosthetic valve pathology: Mid-term results in mitral valve repair
    Balci, Ahmet Yavuz
    Vural, Unsal
    Kizilay, Mehmet
    Donmez, Cevdet
    Akansel, Serdar
    Ozdemir, Fatih
    Aksoy, Rezan
    Abay, Gunseli
    [J]. TURK GOGUS KALP DAMAR CERRAHISI DERGISI-TURKISH JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2018, 26 (01): : 14 - 21
  • [5] Mid-term results of aortic valve preservation:: Remodelling vs. reimplantation
    Graeter, TP
    Aicher, D
    Langer, F
    Wendler, O
    Schäfers, HJ
    [J]. THORACIC AND CARDIOVASCULAR SURGEON, 2002, 50 (01): : 21 - 24
  • [6] Mid-term results of tricuspid annuloplasty using the MC3 ring for secondary tricuspid valve regurgitation
    Yoda, Masataka
    Tanabe, Hiroaki
    Kadoma, Yoshitaka
    Suma, Hisayoshi
    [J]. INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY, 2011, 13 (01) : 7 - 10
  • [7] Mid-term results after sinutubular junction remodelling with aortic cusp repair†
    Asano, Mitsuru
    Kunihara, Takashi
    Aicher, Diana
    El Beyrouti, Hazem
    Rodionycheva, Svetlana
    Schaefers, Hans-Joachim
    [J]. EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 2012, 42 (06) : 1010 - 1015
  • [8] Functional Tricuspid Regurgitation Repair with a Three-Dimensional Design Ring: Short and Mid-Term Results
    Monguio, E.
    de la Rosa, C.
    Alcala, J.
    Maicas, C.
    Buendia, J.
    Almodovar, L.
    Lima, P.
    Canas, A.
    [J]. CARDIOLOGY, 2012, 121 (02) : 122 - 123
  • [9] Mid-term results of valve repairs for atrial functional mitral and tricuspid regurgitations
    Yosuke Takahashi
    Yukio Abe
    Murakami Takashi
    Hiromichi Fujii
    Akimasa Morisaki
    Shinsuke Nishimura
    Yoshito Sakon
    Kazato Ito
    Ayumi Shintani
    Toshihiko Shibata
    [J]. General Thoracic and Cardiovascular Surgery, 2020, 68 : 467 - 476
  • [10] Mid-term results of valve repairs for atrial functional mitral and tricuspid regurgitations
    Takahashi, Yosuke
    Abe, Yukio
    Takashi, Murakami
    Fujii, Hiromichi
    Morisaki, Akimasa
    Nishimura, Shinsuke
    Sakon, Yoshito
    Ito, Kazato
    Shintani, Ayumi
    Shibata, Toshihiko
    [J]. GENERAL THORACIC AND CARDIOVASCULAR SURGERY, 2020, 68 (05) : 467 - 476