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J.Jpn. Surg. Soc.. 122(5): 449-455, 2021


Feature topic

VALVE-SPARING SURGERY FOR AORTIC REGURGITATION AND AORTIC ROOT ANEURYSM

1) Department of Cardiovascular Surgery, Saitama Sekishinkai Hospital, Sayama, Japan
2) Department of Cardiovascular Surgery, Kawasaki Heart Center, Kawasaki, Japan

Atsushi Shimizu1)2), Shuichiro Takanashi2)

The frequency of aortic valve-sparing surgery (AVSS) for aortic regurgitation (AR) and aortic root aneurysm is increasing. It is now possible to understand the underlying cause of these conditions through computed tomography or echocardiography, allowing systematic categorization and selection of the optimal surgical procedure. Excellent short- and mid-term results of AVSS have been reported. However, there are few reports on long-term results and it appears that they are not satisfactory. Bicuspid aortic valve (BAV) surgery can control short-term AR, although reports have indicated that not only AR but also aortic stenosis rapidly becomes a mid-term problem after BAV. Numerous risk factors can be overcome through improved operative methods. However, the outcomes are unsatisfactory when complicated techniques to repair degenerative cusp conditions are performed. The most important aspect is case selection to ensure that AVSS has excellent long-term results in a broad patient population. Treatment for aortic valve and aortic conditions continues to advance, but it is important to review the selection of surgical procedure based on patient age and overall physical condition.


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