Reduction Aortoplasty with Suture Plication Technique for Dilatation of the Ascending Aorta associated with Aortic Valve Disease

Baek, Man Jong; Na, Chan Young; Oh, Sam Sae; Lee, Chang Ha; Whang, Seong Wook; Lee, Cheol; Lim, Hong Gook; Kim, Jae Hyun; Seo, Hong Ju; Kim, Gun Gyk

Abstract

BACKGROUND: Reduction aortoplasty has been advocated for dilatation of the ascending aorta associated with aortic valve disease in older, high-risk patients. We report our results with modification of reduction aortoplasty and aortic valve replacement. MATERIAL AND METHOD: Between July 2001 and December 2002, 14 consecutive patients who underwent modification of reduction aortoplasty, suture plication technique without excision of the dilated aortic wall, were reviewed. The mean age was 63.7+/-6.7 (50 to 75) years. Ten patients had congenital bicuspid aortic valve. Twelve patients had severe aortic valve stenosis and 6 had regurgitation of grade III~IV. The diameter of the ascending aorta was measured before and immediately after surgery and 6 and 12 months postoperatively using echocardiography or computed tomography. Follow-up was complete in an average of 14.7+/-5.4 (7 to 24) months. RESULT: There were no early postoperative deaths and no bleeding complications. Reduction aortoplasty with suture plication technique decreased the diameter of ascending aorta from 49.4+/-3.5 mm preoperatively to 33.2+/-3.4 mm postoperatively (p<0.001). During follow-up, there were no late deaths and no aneurysm recurrence on the ascending aorta.
CONCLUSION
Suture plication technique of reduction aortoplasty without excision of the dilated aortic wall offers good early and short-term results in older, high-risk patients with dilatation of the ascending aorta associated with aortic valve disease. Surgical long-term results of our technique should be evaluated in further studies.