Repair of moderate aortic valve lesions associated with other pathology: an 11-year follow-up

Objectives: The presence of moderate aortic valve (AV) lesions associated w ith other pathologies that require surgery presents a problem since ignorin g or replacing the valve seems unsatisfactory. AV repair can be an attracti ve alternative if shown to perform satisfactory. Methods: To evaluate this possibility, all consecutive AV patients who underwent operation between Ju ly 1988 and July 1999 were reviewed. Out of 1764 AV patients, 239 (14%) und erwent repair and 86 (study group) had moderate lesions associated with mit ral (73), tricuspid (33), coronary disease (5) and others (8). Mean age was 28 years (range 2-66); 78% were rheumatic, 71% were in sinus rhythm and 71 % in NYHA class III-IV. Results: There were seven hospital deaths (8%) and three patients were lost to follow-up (95% complete), Late mortality was 8% and 10-year actuarial survival was 86 +/- 4.5% (excluding hospital mortali ty). There were four (5%) embolic events (actuarial freedom 94 +/- 3.5%). T wenty-one patients required reoperation with two mortalities. The AV was no t touched in five patients. In the remaining 16, the AV was replaced. Only one patient had isolated AV replacement while in all others, additionally, the mitral, tricuspid, or both required surgery. All reoperated patients ha d rheumatic etiology. Actuarial freedom from AV dysfunction at 8 years was 68 +/- 7.5%. Conclusions: Repair of associated moderate AV lesion is worth considering even in a predominantly young rheumatic population. (C) 2001 El sevier Science B.V. All rights reserved.