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Surgical remodeling of the aortic valve

PURPOSE: The authors report a method of surgical treatment of the aortic valve disease, called "Surgical Remodeling of Aortic Valve". MATERIAL AND METHOD: The method consisted of the utilization of the habitual extracorporeal circulation, moderated hipothermia and the infusion of cardioplegic solution in the coronary ostia. The non-coronary valvula is resected and stitches anchored in the aortic valva anulus are given in a way to approximate the resected valvula commissures, in order to turn the trivalvular valva into a bivalvulate one. The Valsalva sinus corresponding to the resected valva stays situated below the commissure and the remaining aortic wall is sutured with a few separated stitches, followed with the conventional aortorraphy. Between March of 1996 and July of 1999, 15 patients were operated with the described technique. Nine were male and the age ranged from 12 to 78 years. Four patients had aortic valve insufficiency, 4 with aortic and mitral insufficiency, 2 with double aortic lesion and coronary artery disease, 2 with ascending aortic disease, 2 with aortic insufficiency and coronary artery disease, and 1 with double dysfunction of aortic and mitral valves. RESULTS: Three patients developed aortic insufficiency on the post-operative and 3 of them were operated on in the late post-operative. Four patients were submitted to hemodynamic study and one of them had a supravalvar gradient estimated at 20 mmHg. Eleven patients were studied by echocardiogram and did not have stenosis. There were neither immediate obits and one occurred in the late post-operative period. Fourteen patients were followed during 30 days to 24 months, and had a good evolution (Functional Class I or II of the NYHA). CONCLUSION: This method for the aortic valve preservation is an alternate option for the surgical treatment of the aortic valve disease.

Aortic valve; Aortic valve insufficiency; Aortic valve insufficiency


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