Aortic valve repair

James S. Tweddell, Andrew N Pelech, Robert D B Jaquiss, Peter C. Frommelt, Kathleen A. Mussatto, George M. Hoffman, S. Bert Litwin

Research output: Contribution to journalArticle

14 Scopus citations

Abstract

Aortic valve replacement options are limited in children, and all of them have disadvantages. Aortic valve repair techniques have evolved slowly and have not gained wide acceptance; however, large series using a variety of techniques demonstrate that valve repair is possible with excellent early hemodynamics and satisfactory intermediate durability. The results of aortic valve repair at the Children's Hospital of Wisconsin are presented. Simple repairs (blunt valvotomy, commissurotomy, or commissurotomy with leaflet thinning) directed at congenital aortic stenosis resulted in 86% ± 5% freedom from reintervention at 10 years. Repair of aortic insufficiency with ventricular septal defect (VSD) resulted in 93.3% ± 6% freedom from reoperation at 10 years. Complex repairs included a combination of techniques and yielded 5-year freedom from reintervention of 83% ± 7% compared with 73% ± 11% for patients undergoing aortic valve replacement (P = .62). Aortic valve repair provides an alternative to aortic valve replacement in selected patients. The utility of aortic valve repair and aortic valve replacement must be measured not only in freedom from reintervention but also in regression of left ventricular mass and exercise testing. Improvement in outcome depends on better patient selection and suitable bioprosthetic materials.

Original languageEnglish (US)
Pages (from-to)112-121
Number of pages10
JournalPediatric Cardiac Surgery Annual
Volume8
Issue number1
DOIs
StatePublished - 2005
Externally publishedYes

Keywords

  • Aortic insufficiency
  • Aortic root
  • Aortic stenosis
  • Aortic valve repair
  • Aortic valve replacement
  • Autograft
  • Bicuspid aortic valve
  • Ross procedure
  • Ventricular septal defect

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Pediatrics, Perinatology, and Child Health

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  • Cite this

    Tweddell, J. S., Pelech, A. N., Jaquiss, R. D. B., Frommelt, P. C., Mussatto, K. A., Hoffman, G. M., & Litwin, S. B. (2005). Aortic valve repair. Pediatric Cardiac Surgery Annual, 8(1), 112-121. https://doi.org/10.1053/j.pcsu.2005.01.013