Search
Close
Search
Advanced Search
Search Menu
AI Discovery Assistant

Abstract

In view of the growing incidence of degenerative origin among the aetiologies of aortic regurgitation, we felt it interesting to report our experience of the surgical treatment of such patients. Out of 313 patients operated on for isolated chronic aortic regurgitation between 1974 and 1989, 102 (32·6%) had aortic regurgitation of degenerative origin and form the basis of this study. The patients were divided into group I (n = 48) without aneurysm of the ascending aorta and group II (54 patients) with anulo-aortic ectasia. The first group was further subdivided according to the diameter of the ascending aorta: in group Ia (23 patients) the aorta was normal with a root diameter of less than 40 mm, while in group Ib (25 patients) the aorta was enlarged (root diameter between 40 and 54 mm). There was no statistically significant difference between the pre-operative and operative parameters of patients in groups Ia and Ib. All underwent aortic valve replacement without associated surgery of the ascending aorta. During a mean follow-up of 58 months, five patients from group Ib had aortic dissection and in another three, an ascending aorta aneurysm developed. Reoperation was performed in six cases. No such complications occurred in group Ia. At 6 years, the proportion of patients free from complications related to the ascending aorta was 100% in group Ia vs 63±6% in group Ib (P < 0·05). In group II, all the patients underwent aortic valve replacement. The modalities of repair of the ascending aorta differed with time. Early in the series, 18 patients had a partial repair; later, complete replacement using the Cabrol technique was preferred in 36 patients. Four operative deaths (7·4%) were noted. The actuarial rate of survival was 74± 7% at 5 years and 59± 9% at 9 years for the entire group and was higher with the complete replacement: 6-year actuarial survival rates were respectively 81% for the complete replacement and 59% for the partial repair group (P < 0·05).

We conclude that in patients without dilatation of the ascending aorta, prognosis after valve replacement is good; in patients with anulo aortic ectasia, a complete replacement provides better long-term results; in patients with dilatation of the ascending aorta but without aneurysm, the potential risk of complication related to ascending aorta and the good long-term results of complete replacement led us to prefer the combination of aortic valve replacement and complete replacement of the ascending aorta.

Anulo aortic ectasia, degenerative aortic regurgitation, aortic regurgitation, floppy valve syndrome, aortic aneurysms, valvular lesions
This content is only available as a PDF.
© 1991 The European Society of Cardiology
Topic:
Issue Section:
Original Papers
You do not currently have access to this article.
Download all slides