P126. Does Aortic Valve Leaflet Plication Increase the Risk of Aortic Regurgitation After Valve-Sparing Root Replacement?
Presented During: Adult Cardiac Poster Session II
Weill Cornell Medicine
New York, NY
United States - Contact Me
Dr. Eilon Ram is a cardiac surgeon in the Department of Cardiothoracic Surgery at Weill Cornell Medicine and an Attending Cardiothoracic Surgeon at NewYork-Presbyterian/Weill Cornell Medical Center.
Dr. Ram earned his medical degree from the Hebrew University in Jerusalem, Israel, and completed both his residency and fellowship in Cardiac Surgery at Sheba Medical Center in Tel Aviv, Israel. He further specialized in cardiothoracic surgery through a fellowship at Weill Cornell Medicine, with advanced training focused on aortic surgery.
Monday, May 4, 2026: 9:00 AM - 4:00 PM
McCormick Place Lakeside Center
Room: Exhibit Hall, Poster Area
Description
Objective: This study compares outcomes of valve-sparing root replacement (VSRR) with and without aortic valve (AV) leaflet plication for repair of aortic insufficiency (AI).
Methods: A retrospective analysis was conducted on 575 patients who underwent VSRR, of whom 77 (13.4%) had VSRR with concomitant AV leaflet plication (VSRR+AVr), while 498 (86.6%) underwent isolated VSRR. The primary outcomes were 10-year freedom from recurrent AI and AV reintervention. Factors associated with moderate or severe AI or AV reintervention were identified using multivariable regression analysis.
Results: The mean age of the cohort was 49.6±14.1 years, with no significant difference between groups (49.5±14.2 vs. 49.7±14.1, p=0.948). Patients in the VSRR+AVr group had a higher incidence of bicuspid AV (64.9% vs. 17.3%, p<0.001) and more preoperative severe AI (68.8% vs. 26.1%, p<0.001). At the end of the operation, no patients had more than mild residual AI, with no significant difference in the rates of mild residual AI between groups (1.3% vs. 2.8%, p=0.696). Perioperative complications were similar between groups (Table). At 10 years, freedom from moderate or severe AI was 87% in the VSRR+AVr group and 89.4% in the isolated VSRR group [HR 0.98 (0.71-1.35), p=0.905]. Leaflet plication was also not associated with a significantly higher risk of AV reintervention [HR 0.86 (0.67-1.1), p=0.232] (Figure).
Conclusion: VSRR with leaflet plication for AI repair does not increase operative mortality or the risk of long-term AI recurrence compared to isolated VSRR. While leaflet plication was predominantly performed in patients with bicuspid valves, the long-term valve function outcomes were comparable. This technique appears safe for patients requiring AI repair in the context of VSRR.
Authors
Eilon Ram (1), Christopher Lau (1), Alexander Gregg (2) (,3), Michael Rogers (4), N. Bryce Robinson (5), Charles Mack (6), Leonard Girardi (7)
Institutions
(1) Weill Cornell Medicine, New York, NY, (2) NYP, New York, NY, (3) Weill Cornell Medicine, N/A, (4) University of South Florida, Tampa, FL, (5) New York Presbyterian, New York, NY, (6) Weill Cornell Medical College, Cornell University, Manhasset, NY, (7) Weill Cornell Medical Center, New York, NY
Methods: A retrospective analysis was conducted on 575 patients who underwent VSRR, of whom 77 (13.4%) had VSRR with concomitant AV leaflet plication (VSRR+AVr), while 498 (86.6%) underwent isolated VSRR. The primary outcomes were 10-year freedom from recurrent AI and AV reintervention. Factors associated with moderate or severe AI or AV reintervention were identified using multivariable regression analysis.
Results: The mean age of the cohort was 49.6±14.1 years, with no significant difference between groups (49.5±14.2 vs. 49.7±14.1, p=0.948). Patients in the VSRR+AVr group had a higher incidence of bicuspid AV (64.9% vs. 17.3%, p<0.001) and more preoperative severe AI (68.8% vs. 26.1%, p<0.001). At the end of the operation, no patients had more than mild residual AI, with no significant difference in the rates of mild residual AI between groups (1.3% vs. 2.8%, p=0.696). Perioperative complications were similar between groups (Table). At 10 years, freedom from moderate or severe AI was 87% in the VSRR+AVr group and 89.4% in the isolated VSRR group [HR 0.98 (0.71-1.35), p=0.905]. Leaflet plication was also not associated with a significantly higher risk of AV reintervention [HR 0.86 (0.67-1.1), p=0.232] (Figure).
Conclusion: VSRR with leaflet plication for AI repair does not increase operative mortality or the risk of long-term AI recurrence compared to isolated VSRR. While leaflet plication was predominantly performed in patients with bicuspid valves, the long-term valve function outcomes were comparable. This technique appears safe for patients requiring AI repair in the context of VSRR.
Authors
Eilon Ram (1), Christopher Lau (1), Alexander Gregg (2) (,3), Michael Rogers (4), N. Bryce Robinson (5), Charles Mack (6), Leonard Girardi (7)
Institutions
(1) Weill Cornell Medicine, New York, NY, (2) NYP, New York, NY, (3) Weill Cornell Medicine, N/A, (4) University of South Florida, Tampa, FL, (5) New York Presbyterian, New York, NY, (6) Weill Cornell Medical College, Cornell University, Manhasset, NY, (7) Weill Cornell Medical Center, New York, NY
Presentation Duration
There is no formal presentation for posters. Your poster will be on display on your assigned day from 9:00AM - 4:00PM
View Submission
ADULT CARDIAC
Aorta and Great Vessels