Long-Term Results of the Leaflet Extension Technique for Rheumatic Aortic Regurgitation: A 20-Year Follow-up
10.5090/kjtcs.2019.52.1.9
- Author:
Yu jin KWAK
1
;
Hyuk AHN
;
Jae Woong CHOI
;
Kyung Hwan KIM
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine.
- Publication Type:Original Article
- Keywords:
Leaflet extension;
Aortic valve, regurgitation;
Rheumatic diseases
- MeSH:
Aortic Valve;
Aortic Valve Insufficiency;
Follow-Up Studies;
Freedom;
Hemorrhage;
Humans;
Incidence;
Mitral Valve Insufficiency;
Mortality;
Pericardium;
Postoperative Complications;
Reoperation;
Rheumatic Diseases;
Risk Factors;
Warfarin
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2019;52(1):9-15
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Although aortic valve repair can reduce prosthesis-related complications, rheumatic aortic regurgitation (AR) caused by leaflet restriction is a significant risk factor for recurrent AR. In this study, we evaluated the long-term results of the leaflet extension technique for rheumatic AR. METHODS: Between 1995 and 2016, 33 patients underwent aortic valve repair using the leaflet extension technique with autologous pericardium for rheumatic pure AR. Twenty patients had severe AR and 9 had combined moderate or greater mitral regurgitation. Their mean age was 32.2±13.9 years. The mean follow-up duration was 18.3±5.8 years. RESULTS: There were no cases of operative mortality, but postoperative complications occurred in 5 patients. Overall survival at 10 and 20 years was 93.5% and 87.1%, respectively. There were no thromboembolic cerebrovascular events, but 4 late deaths occurred, as well as a bleeding event in 1 patient who was taking warfarin. Twelve patients underwent aortic valve reoperation. The mean interval to reoperation was 13.1±6.1 years. Freedom from reoperation at 10 and 20 years was 96.7% and 66.6%, respectively. CONCLUSION: The long-term results of the leaflet extension technique showed acceptable durability and a low incidence of thromboembolic events and bleeding. The leaflet extension technique may be a good option for young patients with rheumatic AR.
