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Functional classification of aortic root/valve abnormalities and their correlation with etiologies and surgical procedures

Khoury, G Ela,b; Glineur, Da,b; Rubay, Ja,b; Verhelst, Ra,b; d'Acoz, Y d'Udekemc; Poncelet, Aa,b; Astarci, Pa,b; Noirhomme, Pha,b; van Dyck, M

Current Opinion in Cardiology: March 2005 - Volume 20 - Issue 2 - p 115-121
doi: 10.1097/01.hco.0000153951.31887.a6
Valvular heart disease

Purpose of review Patients with aortic root pathology may benefit from ‘valve-conservation’ surgery although application of this philosophy is limited by a lack of ‘standardized’ surgical techniques. A functional classification of aortic root and valvular abnormalities has been developed in 260 patients and correlated with the etiology of the pathologic process and the surgical procedure performed.

Early outcome was assessed using hospital records and medium-term follow-up by cardiological review.

Recent findings From January 1995 until March 2001, 260 patients were operated on for aortic root pathology using valve-conserving surgical techniques. Hospital mortality was 2%; intra-operative echocardiography showed residual aortic regurgitation (Grade 1-2) in 11%, none in the remaining patients. Follow-up at a mean of 20 months (87% of patients) showed trivial or Grade 1 aortic regurgitation in 80%.

Summary Application of a simple functional classification for aortic root pathology and aortic valve disease allows the logical application of ‘valve-conserving’ surgical procedures with excellent early and medium-term results.

aDepartments of Cardiovascular and Thoracic Surgery, Cardiology, Cliniques Universitaires Saint-Luc, Brussels, Belgium, bthe Public Health School, Université Catholique de Louvain, Brussels, Belgium, and cRoyal Children's Hospital Cardiac Surgery, Australia

Correspondence to Gebrine El Khoury, Cliniques Universitaires Saint-Luc, U.C.L.90, Service de Chirurgie cardiovasculaire et thoracique, Avenue Hippocrate 10/6107, B-1200 Brussels, Belgium

Tel: +32 2 7646106; fax: +32 2 7648960; e-mail: Elkhoury@chir.ucl.ac.be

© 2005 Lippincott Williams & Wilkins, Inc.