Aortic valve repair with annuloplasty.

Overview

OBJECTIVES: Aortic valve repair procedures for aortic valve regurgitation have been progressively adopted in the last decades. We analysed our results with an external ring annuloplasty and/or leaflet repair. METHODS: From April 2014 to December 2023, 61 consecutive patients underwent aortic valve repair with external Teflon ring annuloplasty. The external ring was made of an 8-9 mm Teflon strip, to reduce the annulus diameter between 21 and 23 mm. Cusp effective height (eH) was assessed with a caliper (not used before 2018), and any cusp prolapse was corrected by free margin plication, to obtain a 9-10 mm eH for all cusps. RESULTS: Patients (72.1%) had severe aortic regurgitation (AR), and associated supracoronary aneurysm repair was performed in 42.6%. No operative death occurred; residual AR more-than-moderate was present in one patient only. The 8-year overall survival was 97.4 ± 2.6%, freedom from endocarditis 98.3 ± 1.7% and freedom from thromboembolism 100%. Recurrence of severe AR with need for reoperation was predicted by the presence of a particularly enlarged aortic annulus (≥28 mm, P < 0.01) and the non-routinary use of cusp caliper (P = 0.03). CONCLUSIONS: The external Teflon ring annuloplasty appears a safe procedure with high overall survival, freedom from endocarditis and freedom from thromboembolism at 10 years. Recurrence of severe AR could be related to patient selection and learning curve.