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Eur J Cardiothorac Surg 2001;20:247-251
© 2001 Elsevier Science NL

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

^a The Department of Cardiovascular Diseases, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia
^b The International Heart Institute of Montana Foundation, Missoula, MT, USA

Received 1 December 2000; received in revised form 11 April 2001; accepted 27 April 2001.

Corresponding author. Tel.: +966-1-4427470; fax: +966-1-4427482
e-mail: alhalees{at}kfshrc.edu.sa

Objectives: The presence of moderate aortic valve (AV) lesions associated with other pathologies that require surgery presents a problem since ignoring or replacing the valve seems unsatisfactory. AV repair can be an attractive alternative if shown to perform satisfactory. Methods: To evaluate this possibility, all consecutive AV patients who underwent operation between July 1988 and July 1999 were reviewed. Out of 1764 AV patients, 239 (14%) underwent repair and 86 (study group) had moderate lesions associated with mitral (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 mortality). There were four (5%) embolic events (actuarial freedom 94±3.5%). Twenty-one patients required reoperation with two mortalities. The AV was not 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 had 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.

Key Words: Rheumatic aortic valve • Aortic valve repair • Multiple valve disease

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