Valve-sparing operations on the aorta has recently been gaining ever increasing popularity due to more detailed study of physiology of the aortic root, as well as promising mid- and long-term results. The world practice uses various techniques making it possible to remove both
ascending aortic aneurysm and
aortic valve insufficiency. The authors herein describe and analyse their experience in performing
reimplantation of the aortic valve in patients with
ascending aortic aneurysm and concomitant aortic insufficiency. Specialists of the clinic of the Novosibirsk Scientific Research Institute for Circulatory Pathology during the period from 2003 to 2013 performed a total of 77 operations of
reimplantation of the aortic valve in patients with
ascending aortic aneurysm and pronounced
aortic valve insufficiency. The majority of patients were men (57 males and 20 females), mean age 53.1±12.2 years (range 21-72). 80% of cases had NYHA functional class II-III circulatory insufficiency (degree 2.3±0.7). Preoperative examination revealed in the majority of patients (97.4%) moderate-to-severe
aortic valve insufficiency and
ascending aortic aneurysm. All patients underwent
reimplantation of the aortic valve. The duration of artificial circulation amounted to 202.4±33 minutes, with the average time of aortic occlusion being 164±28 min. Accompanying procedures (annuloplasty of the mitral valve and/or coronary aortic bypass grafting) were performed in 12 (15.6%) cases. Additional plasty of valvular cusps was carried out in 9 (11.7%) patients, with rethoracotomy required in 5 (6.4%) cases due to haemorrhage. The average period of follow up amounted to 53.3±8.5 (3-115) months. During this time total survival amounted to 91%, with freedom from aortic valve prosthetic repair equalling 93%. The obtained findings suggest that aortic valve
reimplantation into the
prosthesis is a safe intervention and associated with a comparatively low level of operative lethality. Moderate aortic insufficiency at discharge is a predicting factor for repeat surgical intervention, i.e. prosthetic repair of the aortic valve. No association between the preoperative degree of aortic insufficiency, root diameter and durability of the reimplanted valve was revealed.