[Reimplantation of aortic valve; preliminary results in 13 patients].

Objective: To evaluate our initial experience with the reimplantation technique of the aortic valve.

Design: Retrospective.

Method: From January 1st 1998 to January 31st 2000, 13 patients were operated on by the technique as described by David. Mean age was 52.2 years (SD: 11). Median preoperative New York Heart Association (NYHA) functional class was 2/4 and median preoperative degree of aortic regurgitation was 3/4. Surgical indications were initially limited to aneurysmal disease of the aortic root (n = 6) and ascending aorta (n = 4), all complicated by aortic regurgitation. Later on, we also applied the technique in type A aortic dissection (n = 3). The repair was evaluated peroperatively by transoesophageal and postoperatively, by transthoracic echocardiography. The patients were followed postoperatively in the outpatient department.

Results: No technical problems arose that necessitated change or adjustment of the technique. Mean cardiac arrest time was 184 min (SD: 40) and cardiopulmonary bypass time 254 min (SD: 74). The primary aetiology on histopathological examination was medial necrosis in 5 patients and degenerative disease in the others. There was no early nor late mortality and none of the patients was reoperated upon the aortic root. Follow-up was complete at a mean of 12.3 months (SD: 8). Median aortic regurgitation at follow-up was 0.5 (p = 0.0001 versus preoperative) and median NYHA functional class at follow-up was 1 (p = 0.02 versus preoperative).

Conclusion: David's aortic valve reimplantation technique was carried out with a low surgical risk and a low degree of residual aortic regurgitation in aneurysm of the aortic root, aneurysm of the ascending aorta and type A dissection with major destruction of the aortic root.