Valvuloplasty for aortic insufficiency

D. M. Cosgrove, E. R. Rosenkranz, W. G. Hendren, J. C. Bartlett, W. J. Stewart

Research output: Contribution to journalArticle

148 Scopus citations

Abstract

Twenty-eight consecutive patients underwent aortic valvuloplasty for aortic insufficiency caused by leaflet prolapse. The technique involved triangular resection of the free edge of the prolapsing leaflet, annular plication at the commissure, and resection of a raphe when present in bicuspid valves. Mean age of the patients was 46.8 ± 14.4 years. Twenty-six (92.7%) were male. Seventy-five percent of the patients had a bicuspid aortic valve; the remaining valves were tricuspid. The extent of aortic insufficiency was 3.6 ± 0.8 by aortography, 3.1 ± 0.1 by preoperative Doppler echocardiography, and 3.4 ± 0.7 by intraoperative Doppler echocardiography. The amount of aortic insufficiency decreased from 3.4 ± 0.7 to 0.6 ± 0.5 intraoperatively, immediately after repair (p < 0.001). Mean transvalvular gradient by echocardiography was 12.9 ± 6.8 mm Hg. There was one death in a patient who had an intraoperative cerebral vascular accident. Mean follow-up was complete at 6.9 months. One patient had a cerebral vascular accident and one patient required reoperation for recurrent aortic insufficiency caused by partial suture line dehiscence. In 15 patients with late echocardiograms, aortic insufficiency did not progress (0.7 ± 0.6 in the hospital and 0.8 ± 0.5 late). Aortic valve repair for aortic cusp prolapse effectively eliminates aortic insufficiency without causing aortic stenosis. At early follow-up the repair has been stable.

Original languageEnglish (US)
Pages (from-to)571-577
Number of pages7
JournalJournal of Thoracic and Cardiovascular Surgery
Volume102
Issue number4
StatePublished - Jan 1 1991
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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  • Cite this

    Cosgrove, D. M., Rosenkranz, E. R., Hendren, W. G., Bartlett, J. C., & Stewart, W. J. (1991). Valvuloplasty for aortic insufficiency. Journal of Thoracic and Cardiovascular Surgery, 102(4), 571-577.