Aortic Valvuloplasty Using Triangular Resection Technique / 대한흉부외과학회지

ABSTRACT

BACKGROUND: With an increasing awareness of the limitations of both mechanical prostheses and bioprostheses, aortic valvuloplasty has gained attention as an alternative procedure for aortic valve disease. MATERIAL AND METHOD: Eight consecutive patients underwent aortic valvuloplasty caused by leaflet prolapse between June 1999 to June 2000. Mean age of the patients was 18.4+/- 12.6 year. Four paitents(50%) were male. Six patients had tricuspid valves and ventricular septal defect and two patients had bicuspid valves. The extent of aortic insufficiency was 3.5+/- 0.5 by preoperative Doppler echocardiography. The technique involved triangular resection of the free edge of the prolapsed leaflet, annular plication at the commissure, and resection of a raphe when present in bicuspid valves. RESULT: There was no in-hospital mortality or morbidity. Mean follow-up was complete at 11.9+/- 3.6months. There was no late mortality or morbidity. The amount of the severity of aortic insufficiency, as assessed by echocardiography preoperatively, postoperatively and at late follow-up was 3.5+/- 0.5, 0.6+/- 0.5 and 0.8+/- 0.6, respectively(p value = 0.01). There was one patient with grade 2/4 aortic insufficiency and in the other patients, grade 1/2 or trivial aortic insufficiency were detected with late echocardiograms. CONCLUSION: Triangular resection in the patients with aortic leaflet prolapse offers a good early clinical result, but long-term follow-up is necessary.