Our Summary

This research studied the long-term effects of a specific heart surgery called valve-sparing aortic root replacement (VSRR), combined with aortic cusp repair, on patients with aortic regurgitation - a condition where the heart’s aortic valve doesn’t close tightly, causing blood to leak back into the heart.

The researchers performed this surgery on 363 patients and followed up with them over an average period of 71.4 months. They found that 10 and 15 years after the surgery, 85.1% and 78.3% of patients, respectively, hadn’t needed another aortic valve operation. However, patients who had a specific issue called cusp prolapse were more likely to need another operation.

They also found that the overall success of the surgery at 10 and 15 years was 72.4% and 64.0%, respectively. Again, the success rate was higher for patients without cusp prolapse.

In terms of the specific technique used to repair the aortic cusp, they found that the resuspension or reinforcement techniques had better success rates than the central plication technique.

In conclusion, the study shows that the long-term results of VSRR with aortic cusp repair were generally satisfactory and that the resuspension technique seems to be a particularly good method for repairing aortic cusp prolapse in patients with a tricuspid aortic valve (a normal aortic valve with three cusps).

FAQs

  1. What is valve-sparing aortic root replacement (VSRR) and who is it performed on?
  2. What is the long-term success rate of VSRR combined with aortic cusp repair?
  3. What techniques were found to be most successful in repairing the aortic cusp?

Doctor’s Tip

Based on these findings, a doctor might advise a patient undergoing aortic valve replacement to discuss with their surgeon the specific techniques being used for the repair of the aortic cusp. They may also recommend regular follow-up appointments to monitor the success of the surgery and to address any potential issues that may arise, such as cusp prolapse. Additionally, lifestyle changes such as maintaining a healthy diet and regular exercise can help improve overall heart health and potentially reduce the risk of needing another operation in the future.

Suitable For

Patients who are typically recommended aortic valve replacement include those with severe aortic regurgitation, aortic stenosis (narrowing of the aortic valve), or aortic valve insufficiency. These conditions can lead to symptoms such as chest pain, shortness of breath, fatigue, and heart palpitations. Additionally, patients with congenital heart defects, infections of the heart valve, or aortic aneurysms may also be candidates for aortic valve replacement. Ultimately, the decision to undergo aortic valve replacement is made on a case-by-case basis by a cardiologist or cardiothoracic surgeon after considering the patient’s specific condition and medical history.

Timeline

  1. Before surgery: Patients with aortic regurgitation experience symptoms such as shortness of breath, chest pain, fatigue, and heart palpitations. They undergo diagnostic tests such as echocardiograms, MRI, and CT scans to determine the severity of their condition.

  2. Aortic valve replacement surgery: The patient undergoes valve-sparing aortic root replacement (VSRR) combined with aortic cusp repair to correct the aortic regurgitation. The surgery involves repairing or replacing the damaged aortic valve to prevent blood from leaking back into the heart.

  3. Recovery period: After the surgery, the patient will stay in the hospital for a few days to recover. They will be closely monitored for any complications and will undergo physical therapy to regain strength and mobility.

  4. Follow-up appointments: The patient will have regular follow-up appointments with their healthcare provider to monitor their progress and check the function of their new aortic valve. They may also undergo additional tests such as echocardiograms to assess the success of the surgery.

  5. Long-term outcomes: The study shows that the majority of patients who undergo VSRR with aortic cusp repair have successful outcomes and do not require another aortic valve operation in the long term. However, patients with cusp prolapse may be at higher risk of needing another operation. The resuspension technique for repairing the aortic cusp appears to be more effective in these patients.

What to Ask Your Doctor

  1. What is aortic valve replacement surgery and why is it necessary for me?
  2. What are the different types of aortic valve replacement procedures available?
  3. What are the risks and potential complications associated with aortic valve replacement surgery?
  4. What is the expected recovery time and rehabilitation process after aortic valve replacement surgery?
  5. How long can I expect the new valve to last and will I need additional surgeries in the future?
  6. What specific technique will be used to repair my aortic valve during the surgery?
  7. How successful is the valve-sparing aortic root replacement (VSRR) combined with aortic cusp repair procedure in patients with aortic regurgitation?
  8. Am I a candidate for the resuspension or reinforcement techniques for aortic cusp repair, and why?
  9. What are the factors that may increase the likelihood of needing another aortic valve operation in the future?
  10. Are there any lifestyle changes or medications I should consider after aortic valve replacement surgery to ensure the long-term success of the procedure?

Reference

Authors: Kubo S, Tanaka A, Omura A, Tsunemi K, Oka T, Okada K, Okita Y. Journal: Ann Thorac Surg. 2024 Jan;117(1):78-85. doi: 10.1016/j.athoracsur.2023.05.050. Epub 2023 Aug 2. PMID: 37541561