Efficacy of the Controlled Approach of Annular Reduction in Valve-sparing Aortic Root Replacement in Patients with Aortic Regurgitation

P0123 

Abstract Submission 

Hiroshi Tanaka (1), Yoshikatsu Nomura (2), Toshihito Sakamoto (2)

(1) N/A, N/A, (2) Harima Himeji General Medical Center, Himeji, NA

Hiroshi Tanaka    -  Contact Me
N/A

Yoshikatsu Nomura    -  Contact Me
Harima Himeji General Medical Center

Toshihito Sakamoto    -  Contact Me
Harima Himeji General Medical Center

Hiroshi Tanaka    -  Contact Me
N/A

Objective: We identified the specific character of the aortic root morphology after reimplantation by analyzing cardiac computed tomography, and the formula to determine basal ring diameter (target basal ring radius = intraoperatively measured minimum cusp height – target effective height) was suggested. We investigated the efficacy of the controlled approach of basal ring reduction using the formula in reimplantation for valve durability in patients with greater than moderate aortic regurgitation (AR).
Methods: From January 2018 to August 2023, 46 patients underwent reimplantation. Of them, 39 had preoperative greater than moderate aortic regurgitation. Those patients were included in this study. Twenty-one had reimplantation without the formula (Group A) and 18 had with the formula (Group B). We reviewed those patients and compared the mid-term valve durability between two groups.
Results: Age was 61 (37-77) in Group A and 64 (43-75) in Group B. AR classification was 16 and 7 in type I (annular dilation), 4 and 9 in type II (cusp prolapse with cusp bending), and 1 and 2 in Type III (cusp restriction or retraction) in Group A and Group B, respectively. Ten (45%) had severe AR in Group A, whereas 15 (83%) had severe AR in Group B (p<0.05). Follow-up period was 24 (5-47) months in Group A and 15 (3-41) in Group B. Mean graft diameter was 28mm in Group A and 26.7mm in Group B. Regarding cusp repair techniques, only central plication was used in 10 of Group A, whereas central plication was used in 7, free margin resuspension in 6, and subcommissural annuloplasty in 1 of Group B. Freedom from AR greater than moderate at 3 years was 67±12% in Group A and 94±6% in Group B (p<0.05).
Conslusions: The controlled approach of basal ring reduction using the formula in reimplantation had positive effect for mid-term aortic valve durability in patients with aortic regurgitation.

Aortic Root