Advances of aortic valve repair for aortic regurgitation_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LU Zirun ,  WANG Dongjin

Department of Cardiothoracic Surgery, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, 210008, P.R.China;

Corresponding author：

WANG Dongjin, Email: gldjw@163.com

Keywords：

Aortic valve repair; aortic regurgitation; aortic valve replacement

DOI：

10.7507/1007-4848.201608031

Video：

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The first aortic valve repair was performed in 1958, but the clinical outcome was limited. Since the invention of prosthetic valves, aortic valve replacement has become and still maintained the dominated surgical treatment option. As the impact of the prosthetic valve-related event to quality of life of the patients and the studies of the mechanism of aortic regurgitation and the functional anatomy of aortic root grow, the application of aortic valve repair gets more popular, and the short- and mid-term outcomes are good.

Citation： LU Zirun, WANG Dongjin. Advances of aortic valve repair for aortic regurgitation. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2018, 25(2): 177-180. doi: 10.7507/1007-4848.201608031 Copy

1.	Garamella JJ, Andersen JG, Oropeza R, et al. A new concept in the surgical treatment of aortic insufficiency. Minn Med, 1958, 41(4): 260-262.
2.	Taylor WJ, Thrower WB, Black H, et al. The surgical correction of aortic insufficiency by circumclusion. J Thorac Surg, 1958, 35(2): 192-205.
3.	Starzl TE, Cruzat EP, Walker FB, et al. A technique for bicuspidization of the aortic valve. J Thorac Cardiovasc Surg, 1959, 38: 262-270.
4.	Murphy JP. The surgical correction of syphilitic aortic insufficiency. J Thorac Cardiovasc Surg, 1960, 40: 524-528.
5.	Starr A, Menashe V, Dotter C. Surgical correction of aortic insufficiency associated with ventricular septal defect. Surg Gynecol Obstet, 1960, 111: 71-76.
6.	张卫. 主动脉瓣成形术治疗主动脉瓣疾病的现状及展望. 心血管外科杂志 (电子版), 2014, 3(3): 115-118.
7.	Aicher D, Fries R, Rodionycheva S, et al. Aortic valve repair leads to a low incidence of valve-related complications. Eur J Cardiothorac Surg, 2010, 37(1): 127-132.
8.	David TE, Feindel CM. An aortic valve-sparing operation for patients with aortic incompetence and aneurysm of the ascending aorta. J Thorac Cardiovasc Surg, 1992, 103(4): 617-622.
9.	Sarsam MA, Yacoub M. Remodeling of the aortic valve anulus. J Thorac Cardiovasc Surg, 1993, 105(3): 435-438.
10.	Boodhwani M, de Kerchove L, Glineur D, et al. Repair-oriented classification of aortic insufficiency: impact on surgical techniques and clinical outcomes. J Thorac Cardiovasc Surg, 2009, 137(2): 286-294.
11.	Roman MJ, Devereux RB, Niles NW, et al. Aortic root dilatation as a cause of isolated, severe aortic regurgitation. Prevalence, clinical and echocardiographic patterns, and relation to left ventricular hypertrophy and function. Ann Intern Med, 1987, 106(6): 800-807.
12.	Devereux RB, de Simone G, Arnett DK, et al. Normal limits in relation to age, body size and gender of two-dimensional echocardiographic aortic root dimensions in persons ≥15 years of age. Am J Cardiol, 2012, 110(8): 1189-1194.
13.	Thubrikar MJ, Labrosse MR, Zehr KJ, et al. Aortic root dilatation may alter the dimensions of the valve leaflets. Eur J Cardiothorac Surg, 2005, 28(6): 850-855.
14.	Nkomo VT, Enriquez-Sarano M, Ammash NM, et al. Bicuspid aortic valve associated with aortic dilatation: a community-based study. Arterioscler Thromb Vasc Biol, 2003, 23(2): 351-356.
15.	Aicher D, Schafers HJ. Aortic valve repair--current status, indications, and outcomes. Semin Thorac Cardiovasc Surg, 2012, 24(3): 195-201.
16.	Asano M, Kunihara T, Aicher D, et al. Mid-term results after sinutubular junction remodelling with aortic cusp repair. Eur J Cardiothorac Surg, 2012, 42(6): 1010-1015.
17.	Kunihara T, Aicher D, Rodionycheva S, et al. Preoperative aortic root geometry and postoperative cusp configuration primarily determine long-term outcome after valve-preserving aortic root repair. J Thorac Cardiovasc Surg, 2012, 143(6): 1389-1395.
18.	Schafers HJ, Langer F, Glombitza P, et al. Aortic valve reconstruction in myxomatous degeneration of aortic valves: are fenestrations a risk factor for repair failure?. J Thorac Cardiovasc Surg, 2010, 139(3): 660-664.
19.	Schafers HJ, Aicher D, Langer F, et al. Preservation of the bicuspid aortic valve. Ann Thorac Surg, 2007, 83(2): S740-S745, S785-S790.
20.	Schafers HJ, Bierbach B, Aicher D. A new approach to the assessment of aortic cusp geometry. J Thorac Cardiovasc Surg, 2006, 132(2): 436-438.
21.	Cabrol C, Cabrol A, Guiraudon G, et al.Treatment of aortic insufficiency by means of aortic annuloplasty. Arch Mal Coeur Vaiss, 1966, 59(9): 1305-1312.
22.	Carpentier A. Cardiac valve surgery--the " French correction”. J Thorac Cardiovasc Surg, 1983, 86(3): 323-337.
23.	Fattouch K, Castrovinci S, Murana G, et al. Functional annulus remodelling using a prosthetic ring in tricuspid aortic valve repair: mid-term results. Interact Cardiovasc Thorac Surg, 2013, 18(1): 49-55.
24.	le Polain DWJ, Pouleur AC, Robert A, et al. Mechanisms of recurrent aortic regurgitation after aortic valve repair: predictive value of intraoperative transesophageal echocardiography. JACC Cardiovasc Imaging, 2009, 2(8): 931-939.
25.	de Kerchove L, Jashari R, Boodhwani M, et al. Surgical anatomy of the aortic root: Implication for valve-sparing reimplantation and aortic valve annuloplasty. J Thorac Cardiovasc Surgery, 2015, 149(2): 425-433.
26.	Fattouch K, Castrovinci S, Murana G, et al. Functional annulus remodelling using a prosthetic ring in tricuspid aortic valve repair: mid-term results. Interact Cardiovasc Thoracic Surgery, 2013, 18(1): 49-55.
27.	David TE, Armstrong S, Maganti M, et al. Long-term results of aortic valve-sparing operations in patients with Marfan syndrome. J Thorac Cardiovasc Surg, 2009, 138(4): 859-864.
28.	Kunihara T, Aicher D, Rodionycheva S, et al. Preoperative aortic root geometry and postoperative cusp configuration primarily determine long-term outcome after valve-preserving aortic root repair. J Thorac Cardiovasc Surg, 2012, 143(6): 1389-1395.
29.	El Khoury G, de Kerchove L. Principles of aortic valve repair. J Thorac Cardiovasc Surg, 2013, 145(3): S26-S29.
30.	Aicher D, Langer F, Adam O, et al. Cusp repair in aortic valve reconstruction: does the technique affect stability?. J Thorac Cardiovasc Surg, 2007, 134(6): 1533-1539.
31.	de Kerchove L, Glineur D, Poncelet A, et al. Repair of aortic leaflet prolapse: a ten-year experience. Eur J Cardiothorac Surg, 2008, 34(4): 785-791.
32.	David TE, Armstrong S. Aortic cusp repair with Gore-Tex sutures during aortic valve-sparing operations. J Thorac Cardiovasc Surg, 2010, 139(5): 1340-1342.
33.	Sievers HH, Schmidtke C. A classification system for the bicuspid aortic valve from 304 surgical specimens. J Thorac Cardiovasc Surg, 2007, 133(5): 1226-1233.
34.	Duran CM, Alonso J, Gaite L, et al. Long-term results of conservative repair of rheumatic aortic valve insufficiency. Eur J Cardiothorac Surg, 1988, 2(4): 217-223.
35.	Bozbuga N, Erentug V, Kirali K, et al. Midterm results of aortic valve repair with the pericardial cusp extension technique in rheumatic valve disease. Ann Thorac Surg, 2004, 77(4): 1272-1276.
36.	de Waroux J, Pouleur AC, Robert A, et al. Mechanisms of recurrent aortic regurgitation after aortic valve repair predictive value of intraoperative transesophageal echocardiography. JACC Cardiovasc Imaging, 2009, 2(8): 931-939.
37.	Aicher D, Fries R, Rodionycheva S, et al. Aortic valve repair leads to a low incidence of valve-related complications. Eur J Cardiothorac Surg, 2010, 37(1): 127-132.
38.	Saczkowski R, Malas T, de Kerchove L, et al. Systematic review of aortic valve preservation and repair. Ann Cardiothorac Surg, 2013, 2(1): 3-9.

1. Garamella JJ, Andersen JG, Oropeza R, et al. A new concept in the surgical treatment of aortic insufficiency. Minn Med, 1958, 41(4): 260-262.
2. Taylor WJ, Thrower WB, Black H, et al. The surgical correction of aortic insufficiency by circumclusion. J Thorac Surg, 1958, 35(2): 192-205.
3. Starzl TE, Cruzat EP, Walker FB, et al. A technique for bicuspidization of the aortic valve. J Thorac Cardiovasc Surg, 1959, 38: 262-270.
4. Murphy JP. The surgical correction of syphilitic aortic insufficiency. J Thorac Cardiovasc Surg, 1960, 40: 524-528.
5. Starr A, Menashe V, Dotter C. Surgical correction of aortic insufficiency associated with ventricular septal defect. Surg Gynecol Obstet, 1960, 111: 71-76.
6. 张卫. 主动脉瓣成形术治疗主动脉瓣疾病的现状及展望. 心血管外科杂志 (电子版), 2014, 3(3): 115-118.
7. Aicher D, Fries R, Rodionycheva S, et al. Aortic valve repair leads to a low incidence of valve-related complications. Eur J Cardiothorac Surg, 2010, 37(1): 127-132.
8. David TE, Feindel CM. An aortic valve-sparing operation for patients with aortic incompetence and aneurysm of the ascending aorta. J Thorac Cardiovasc Surg, 1992, 103(4): 617-622.
9. Sarsam MA, Yacoub M. Remodeling of the aortic valve anulus. J Thorac Cardiovasc Surg, 1993, 105(3): 435-438.
10. Boodhwani M, de Kerchove L, Glineur D, et al. Repair-oriented classification of aortic insufficiency: impact on surgical techniques and clinical outcomes. J Thorac Cardiovasc Surg, 2009, 137(2): 286-294.
11. Roman MJ, Devereux RB, Niles NW, et al. Aortic root dilatation as a cause of isolated, severe aortic regurgitation. Prevalence, clinical and echocardiographic patterns, and relation to left ventricular hypertrophy and function. Ann Intern Med, 1987, 106(6): 800-807.
12. Devereux RB, de Simone G, Arnett DK, et al. Normal limits in relation to age, body size and gender of two-dimensional echocardiographic aortic root dimensions in persons ≥15 years of age. Am J Cardiol, 2012, 110(8): 1189-1194.
13. Thubrikar MJ, Labrosse MR, Zehr KJ, et al. Aortic root dilatation may alter the dimensions of the valve leaflets. Eur J Cardiothorac Surg, 2005, 28(6): 850-855.
14. Nkomo VT, Enriquez-Sarano M, Ammash NM, et al. Bicuspid aortic valve associated with aortic dilatation: a community-based study. Arterioscler Thromb Vasc Biol, 2003, 23(2): 351-356.
15. Aicher D, Schafers HJ. Aortic valve repair--current status, indications, and outcomes. Semin Thorac Cardiovasc Surg, 2012, 24(3): 195-201.
16. Asano M, Kunihara T, Aicher D, et al. Mid-term results after sinutubular junction remodelling with aortic cusp repair. Eur J Cardiothorac Surg, 2012, 42(6): 1010-1015.
17. Kunihara T, Aicher D, Rodionycheva S, et al. Preoperative aortic root geometry and postoperative cusp configuration primarily determine long-term outcome after valve-preserving aortic root repair. J Thorac Cardiovasc Surg, 2012, 143(6): 1389-1395.
18. Schafers HJ, Langer F, Glombitza P, et al. Aortic valve reconstruction in myxomatous degeneration of aortic valves: are fenestrations a risk factor for repair failure?. J Thorac Cardiovasc Surg, 2010, 139(3): 660-664.
19. Schafers HJ, Aicher D, Langer F, et al. Preservation of the bicuspid aortic valve. Ann Thorac Surg, 2007, 83(2): S740-S745, S785-S790.
20. Schafers HJ, Bierbach B, Aicher D. A new approach to the assessment of aortic cusp geometry. J Thorac Cardiovasc Surg, 2006, 132(2): 436-438.
21. Cabrol C, Cabrol A, Guiraudon G, et al.Treatment of aortic insufficiency by means of aortic annuloplasty. Arch Mal Coeur Vaiss, 1966, 59(9): 1305-1312.
22. Carpentier A. Cardiac valve surgery--the " French correction”. J Thorac Cardiovasc Surg, 1983, 86(3): 323-337.
23. Fattouch K, Castrovinci S, Murana G, et al. Functional annulus remodelling using a prosthetic ring in tricuspid aortic valve repair: mid-term results. Interact Cardiovasc Thorac Surg, 2013, 18(1): 49-55.
24. le Polain DWJ, Pouleur AC, Robert A, et al. Mechanisms of recurrent aortic regurgitation after aortic valve repair: predictive value of intraoperative transesophageal echocardiography. JACC Cardiovasc Imaging, 2009, 2(8): 931-939.
25. de Kerchove L, Jashari R, Boodhwani M, et al. Surgical anatomy of the aortic root: Implication for valve-sparing reimplantation and aortic valve annuloplasty. J Thorac Cardiovasc Surgery, 2015, 149(2): 425-433.
26. Fattouch K, Castrovinci S, Murana G, et al. Functional annulus remodelling using a prosthetic ring in tricuspid aortic valve repair: mid-term results. Interact Cardiovasc Thoracic Surgery, 2013, 18(1): 49-55.
27. David TE, Armstrong S, Maganti M, et al. Long-term results of aortic valve-sparing operations in patients with Marfan syndrome. J Thorac Cardiovasc Surg, 2009, 138(4): 859-864.
28. Kunihara T, Aicher D, Rodionycheva S, et al. Preoperative aortic root geometry and postoperative cusp configuration primarily determine long-term outcome after valve-preserving aortic root repair. J Thorac Cardiovasc Surg, 2012, 143(6): 1389-1395.
29. El Khoury G, de Kerchove L. Principles of aortic valve repair. J Thorac Cardiovasc Surg, 2013, 145(3): S26-S29.
30. Aicher D, Langer F, Adam O, et al. Cusp repair in aortic valve reconstruction: does the technique affect stability?. J Thorac Cardiovasc Surg, 2007, 134(6): 1533-1539.
31. de Kerchove L, Glineur D, Poncelet A, et al. Repair of aortic leaflet prolapse: a ten-year experience. Eur J Cardiothorac Surg, 2008, 34(4): 785-791.
32. David TE, Armstrong S. Aortic cusp repair with Gore-Tex sutures during aortic valve-sparing operations. J Thorac Cardiovasc Surg, 2010, 139(5): 1340-1342.
33. Sievers HH, Schmidtke C. A classification system for the bicuspid aortic valve from 304 surgical specimens. J Thorac Cardiovasc Surg, 2007, 133(5): 1226-1233.
34. Duran CM, Alonso J, Gaite L, et al. Long-term results of conservative repair of rheumatic aortic valve insufficiency. Eur J Cardiothorac Surg, 1988, 2(4): 217-223.
35. Bozbuga N, Erentug V, Kirali K, et al. Midterm results of aortic valve repair with the pericardial cusp extension technique in rheumatic valve disease. Ann Thorac Surg, 2004, 77(4): 1272-1276.
36. de Waroux J, Pouleur AC, Robert A, et al. Mechanisms of recurrent aortic regurgitation after aortic valve repair predictive value of intraoperative transesophageal echocardiography. JACC Cardiovasc Imaging, 2009, 2(8): 931-939.
37. Aicher D, Fries R, Rodionycheva S, et al. Aortic valve repair leads to a low incidence of valve-related complications. Eur J Cardiothorac Surg, 2010, 37(1): 127-132.
38. Saczkowski R, Malas T, de Kerchove L, et al. Systematic review of aortic valve preservation and repair. Ann Cardiothorac Surg, 2013, 2(1): 3-9.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Advances of aortic valve repair for aortic regurgitation

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