P123. Efficacy of the Controlled Approach of Annular Reduction in Valve-sparing Aortic Root Replacement in Patients with Aortic Regurgitation
Presented During: POD Abstracts (Available for viewing in the exhibit hall for the duration of the meeting)
Himeji, Hyogo
Japan - Contact Me
1996 Kobe univeristy
2007-2016 National Cerebral and Cardiovascular Rearch Center
2016-2018 Professor of Minimum Invasive Surgery, Kobe university
2019- Harima Himeji General Medical Cnter, Cardiovascular Surgery
Thursday, April 25, 2024: 5:38 PM - 7:00 PM
Sheraton Times Square
Room: Central Park
Description
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.
Authors
Hiroshi Tanaka (1), Yoshikatsu Nomura (2), Toshihito Sakamoto (2)
Institutions
(1) N/A, N/A, (2) Harima Himeji General Medical Center, Himeji, NA
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.
Authors
Hiroshi Tanaka (1), Yoshikatsu Nomura (2), Toshihito Sakamoto (2)
Institutions
(1) N/A, N/A, (2) Harima Himeji General Medical Center, Himeji, NA
Presentation Duration
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