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Editorial
. 2021 Jan 28:7:121-125.
doi: 10.1016/j.xjtc.2021.01.030. eCollection 2021 Jun.

The art of aortic valve repair

Lars G Svensson  1
Affiliations
Editorial

The art of aortic valve repair

Lars G Svensson. JTCVS Tech. .
No abstract available

Keywords: CLASS; Cabrol stitch; Trussler stitch; aorta; cardiac surgery; figure-of-eight suture; leaflet repair; reimplantation; valve leaflet.

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Figures

None
Valve repair without reimplantation with Cabrol, figure-of-8 sutures (internal 1, 2/external 3).
Figure 1
Figure 1
Use of different types of repair methods on aortic valves.
Figure 2
Figure 2
A, Newer techniques for aortic valve repair, the first of which involves placing figure-of-8 suspension sutures at the leading edge of the cusps. Cabrol commissuroplasty showing 2 commissural stitches (pledgeted and commissural approximation) and central plication (Reproduced with permission from Zeeshan and colleagues.1). B, Intraoperative photographs of bicuspid repairs with Cabrol, plication, leaflet edge, and figure-of-8 sutures. Note the use of a Hegar dilator to ensure that no stenosis is created.
Figure 3
Figure 3
Suturing commissures at a higher level. A, Mobilizing commissure for a large root. B, Closing gaps in aortic root incisions. C, Reattachment of commissures resuspended in a tube graft at a higher level.
Figure 4
Figure 4
Trileaflet valve repair with a separate ascending tube graft. Note the Cabrol sutures at the base of commissures and figure-of-8 suspension sutures. The patient went from 3+ regurgitation to none.
Figure 5
Figure 5
Steps in modified reimplantation with pledgeted sutures, a Hegar dilator for normal body surface area anular size (not shown), and completion of reimplantation/repair.
Figure 6
Figure 6
Freedom from reoperation after reimplantation.
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Comment in

References

    1. Zeeshan A., Idrees J.J., Johnston D.R., Rajeswaran J., Roselli E.E., Soltesz E.G., et al. Durability of aortic valve cusp repair with and without annular support. Ann Thorac Surg. 2018;105:739–748. - PubMed
    1. Svensson L.G., Deglurkar I., Ung J., Pettersson G., Gillinov A.M., D'Agostino R.S., et al. Aortic valve repair and root preservation by remodeling, reimplantation, and tailoring: technical aspects and early outcome. J Card Surg. 2007;22:473–479. - PubMed
    1. Svensson L.G., Blackstone E.H., Alsalihi M., Batizy L.H., Roselli E.E., McCullough R., et al. Midterm results of David reimplantation in patients with connective tissue disorder. Ann Thorac Surg. 2013;95:555–562. - PubMed
    1. Svensson L.G., Batizy L.H., Blackstone E.H., Gillinov A.M., Moon M.C., D'Agostino R.S., et al. Results of matching valve and root repair to aortic valve and root pathology. J Thorac Cardiovasc Surg. 2011;142:1491–1498.e7. - PubMed
    1. Svensson L.G., Cooper M., Batizy L.H., Nowicki E.R. Simplified David reimplantation with reduction of anular size and creation of artificial sinuses. Ann Thorac Surg. 2010;89:1443–1447. - PubMed

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