Ba. Konstantinov et al., LONG-TERM RESULTS OF PLASTIC RECONSTRUCTIONS IN ACQUIRED AORTIC VALVULAR DISEASE, Journal of Cardiovascular Surgery, 35(6), 1994, pp. 125-128
Plastic surgery in acquired aortic valvular disease was performed in 1
64 patients. Among them, 9 had the isolated aortic valvular injury; 13
0 mitral-aortic defects; and 25 three-valve injuries. The restoration
of the injured valve function was achieved, as a rule, using a combina
tion of surgical methods: commissurotomy or wedge resection of the fib
rous tissue in the commissurial area; parietal resection; the aortic r
oot frame plasty; perforation hole plasty; the allogenic valvuloaortic
complex sector transplantation; and wedge resection or isometric cusp
plication in the commissurial area. Calcinosis was not a contraindica
tion to surgery, if it could be removed completely without the cusp cl
osing function disturbances. The hospital mortality rate was 8%. After
hospital treatment all the patients were followed-up: 108 for over 1
year, and the maximum term of the follow-up was 7 years. From 1 to 4 y
ears postoperatively, 4 patients were reoperated due to the appearance
of aortic insufficiency. The causes of relapse were: infectious endoc
arditis (3 patients); active rheumatic process (1 patient); and progre
ssive dilatation of the fibrous ring (1 patient). During the follow-up
8 patients died: 6 of infectious endocarditis with mitral prosthetic
injury; and in 2 the cause of death was not clear. The study of immedi
ate and long-term aortic valvuloplasty results based on the clinical e
xperience of 164 operations allows to recommend the elaborated princip
les of the aortic valve surgical reconstruction for a wide application
in cardiac surgery.