Valve sparing aortic root repair with patch technique

Objectives: Aortic root repair with patch technique has been established at our clinic as the technique of choice for valve-sparing surgery of aortic root diseases combined with aortic regurgitation. The aim of the study was to evaluate the intermediate clinical and echocardiographic results.

Methods: Between September 2000 and August 2005, 51 patients with ascending aorta disease and aortic valve insufficiency were operated on using the patch technique. 14 patients had an acute type A aortic dissection and 37 patients had an ascending aortic aneurysm. Two patients had Marfan syndrome. Replacement of all sinuses of Valsalva was necessary in only 1 patient in the dissection-group as opposed to the aneurysm-group, where 16 patients needed complete replacement. However, in all patients the acoronary sinus had to be replaced.

Results: Two patients (4%) died during the 30-day postoperative course. During the follow-up of up to 5 years there were three non-cardiac deaths. In two patients the aortic valve had to be replaced before discharge due to recurrent insufficiency. In 47 patients the aortic valve was competent at discharge and the echocardiographic findings remained in all (44) survivors favorably unchanged throughout the follow-up.

Conclusion: Valve sparing aortic root repair with patch technique allows, in selected patients, individualized reconstruction of the sinuses of Valsalva and sinotubular junction resulting in a good function of the aortic valve. The technique is especially advantageous in patients in whom not all sinuses have to be replaced.