Recent Early Operative Outcomes of Comprehensive Aortic Root & Valve Reconstruction (CARVAR) Procedure.
- Author:
Sung Jun LEE
1
;
Je Kyoun SHIN
;
Dong Chan KIM
;
Jin Sik KIM
;
Jun Seok KIM
;
Hyun Keun CHEE
;
Meong Gun SONG
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Konkuk University Medical Center, School of Medicine, Konkuk University, Korea. jekshin@kuh.ac.kr
- Publication Type:Original Article
- Keywords:
Aortic valve surgery;
Aortic root
- MeSH:
Aortic Aneurysm;
Aortic Valve;
Aortic Valve Insufficiency;
Aortic Valve Stenosis;
Congenital Abnormalities;
Constriction, Pathologic;
Dilatation, Pathologic;
Endocarditis;
Follow-Up Studies;
Humans;
Perfusion;
Sinus of Valsalva
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2009;42(6):696-703
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: A Comprehensive Aortic Root and Valve Reconstruction (CARVAR) procedure is comprised of aortic root wall reconstruction and corrections of the leaflets for treating various aortic valve diseases. We evaluated our recent early clinical experience with the CARVAR procedure. MATERIAL AND METHOD: From October 2007 to September 2008, 114 cases (66 males) of CARVAR procedures were performed. The mean patient age was 53 years (range: 14~84). The patients were divided into 4 groups: 1) the AAR group: aortic regurgitation with aortic root wall deformity such as annulo-aortic ectasia or ascending aortic aneurysm (n=18), 2) the IAR group: isolated AR with leaflet abnormality (n=42), 3) the IAS group: isolated aortic stenosis (n=51) and 4) the PAVR group: previous aortic valve replacement (n=3). Sinotubular junction (STJ) reduction was done in all the patients, leaflet correction was done in 10 of the AAR group patients and in all the patients of the other groups, annulus reduction was done in 14 of the AAR group patients and in 6 of the IAR group patients. Aortic dissection was excluded from this analysis. RESULT: There was no mortality or follow-up death. The diameter of the aortic sinus decreased from 54.6+/-8.4 mm to 38.3+/-3.8 mm in the AAR group, the mean AR grade decreased from 3.2 to 0.2 in the IAR group, the mean aortic valve pressure gradient decreased from 47.1+/-24.4 mmHg to 15.1+/-11.7 mmHg in the IAS group and the mean AR grade decreased to 0 in the PAVR group. Balloon type coronary perfusion cannula-related coronary ostial stenosis developed in 4 patients and this was treated with OPCAB in three patients and with PTCA in one patient. Two patients developed postoperative infectious endocarditis. All the patients were discharged and followed up in a stable condition. CONCLUSION: The CARVAR procedure showed excellent short term results, but a good further follow up result is required to apply this procedure to most kinds of aortic valve diseases.
