Universität zu Köln

Rankin, J. Scott, Mazzitelli, Domenico, Fischlein, Theodor, Choi, Yeong-Hoon, Pirk, Jan, Pfeiffer, Steffen, Wei, Lawrence M. and Badhwar, Vinay (2018). Geometric Ring Annuloplasty for Aortic Valve Repair During Aortic Aneurysm Surgery Two-Year Clinical Trial Results. Innovations, 13 (4). S. 248 - 254. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1559-0879

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Abstract

Objective: An aortic annuloplasty ring could be useful for aortic valve repair. This trial evaluated intermediate-term outcomes of internal geometric ring annuloplasty for repair of trileaflet and bicuspid aortic insufficiency associated with ascending aortic and/or aortic root aneurysms. Methods: Under regulatory supervision, 47 patients with aortic insufficiency and ascending aortic (n = 22) and/or aortic root (n = 25) aneurysms were managed with aortic valve repair and aneurysm resection. Valve repair was performed using trileaflet (n = 40) or bicuspid (n = 7) internal geometric rings, together with leaflet reconstruction. Ascending aortic and/or remodeling root replacements were accomplished with Dacron grafts 5 to 7 mm larger than the rings. An Echo Core Lab provided independent echocardiographic assessments, and changes over time were evaluated by Friedman tests. Results: Mean +/- SD age was 60 +/- 14 years, 57% (27/47) were male, 15% (7/47) had bicuspid valves, 87% (41/47) had moderate-to-severe aortic insufficiency, and 13% (6/47) had mild aortic insufficiency. All patients had annular dilatation, with a mean +/- SD of 26.5 +/- 2.6 mm before repair, and mean +/- SD ring sizes were 21.7 +/- 1.7 mm. Follow-up was 42 months (mean = 27 months). No operative mortality or valve-related complications occurred. Two patients died beyond 1 year from nonvalve-related causes. One patient required valve replacement for repair failure. Survival free of complications or valve replacement was 94% at 2 years. Significant reduction in aortic insufficiency and New York Heart Association class were observed (P < 0.0001), and valve gradients remained low. No heart block or direct ring complications occurred. Conclusions: In preliminary regulatory studies, aortic ring annuloplasty seemed safe and effective during aortic aneurysm surgery. This approach could help standardize aortic valve repair.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Rankin, J. Scott UNSPECIFIED UNSPECIFIED UNSPECIFIED Mazzitelli, Domenico UNSPECIFIED UNSPECIFIED UNSPECIFIED Fischlein, Theodor UNSPECIFIED UNSPECIFIED UNSPECIFIED Choi, Yeong-Hoon UNSPECIFIED UNSPECIFIED UNSPECIFIED Pirk, Jan UNSPECIFIED UNSPECIFIED UNSPECIFIED Pfeiffer, Steffen UNSPECIFIED UNSPECIFIED UNSPECIFIED Wei, Lawrence M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Badhwar, Vinay UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-180436
DOI:	10.1097/IMI.0000000000000539
Journal or Publication Title:	Innovations
Volume:	13
Number:	4
Page Range:	S. 248 - 254
Date:	2018
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Place of Publication:	PHILADELPHIA
ISSN:	1559-0879
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language SPARING-ROOT REPLACEMENT; REIMPLANTATION; REGURGITATION; OPERATIONS; SURVIVAL; RISK Multiple languages Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/18043