Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jul 3;40(7):ivaf146.
doi: 10.1093/icvts/ivaf146.

Aortic valve repair with annuloplasty

Francesco Giosuè Irace  1 , Ilaria Chirichilli  1 , Raffaele Scaffa  2 , Chiara Bellome  3 , Mario Torre  4 , Andrea Salica  2 , Giulio Folino  2 , Ruggero De Paulis  2   3
Affiliations

Aortic valve repair with annuloplasty

Francesco Giosuè Irace et al. Interdiscip Cardiovasc Thorac Surg. .

Abstract

Objectives: Aortic valve repair procedures for aortic valve regurgitation have been progressively adopted in the last decades. We analysed our results with an external ring annuloplasty and/or leaflet repair.

Methods: From April 2014 to December 2023, 61 consecutive patients underwent aortic valve repair with external Teflon ring annuloplasty. The external ring was made of an 8-9 mm Teflon strip, to reduce the annulus diameter between 21 and 23 mm. Cusp effective height (eH) was assessed with a caliper (not used before 2018), and any cusp prolapse was corrected by free margin plication, to obtain a 9-10 mm eH for all cusps.

Results: Patients (72.1%) had severe aortic regurgitation (AR), and associated supracoronary aneurysm repair was performed in 42.6%. No operative death occurred; residual AR more-than-moderate was present in one patient only. The 8-year overall survival was 97.4 ± 2.6%, freedom from endocarditis 98.3 ± 1.7% and freedom from thromboembolism 100%. Recurrence of severe AR with need for reoperation was predicted by the presence of a particularly enlarged aortic annulus (≥28 mm, P < 0.01) and the non-routinary use of cusp caliper (P = 0.03).

Conclusions: The external Teflon ring annuloplasty appears a safe procedure with high overall survival, freedom from endocarditis and freedom from thromboembolism at 10 years. Recurrence of severe AR could be related to patient selection and learning curve.

Keywords: aortic annulus; aortic regurgitation; aortic root; aortic valve; aortic valve repair.

PubMed Disclaimer

Conflict of interest statement

All authors have nothing to disclose.

Figures

None
Graphical abstract
Figure 1:
Figure 1:
(A) Annuloplasty Teflon strip placement. (B) Cusp effective height assessment.
Figure 2:
Figure 2:
Combined Kaplan–Meier curve showing overall survival + freedom from reoperation, reoperation incidence and death incidence.
Figure 3:
Figure 3:
Kaplan–Meier curves showing freedom from reoperation and from recurrent aortic regurgitation (AR) ≥ 3+, comparing the use of caliper vs eyeballing in leaflet assessment.
Figure 4:
Figure 4:
(A) Kaplan–Meier curves showing freedom from reoperation and from recurrent aortic regurgitation (AR) ≥ 3+, comparing native annulus <28 mm vs ≥28 mm. (B) Kaplan–Meier curves showing freedom from reoperation and from recurrent AR ≥ 3+, comparing early experience vs late experience.
See this image and copyright information in PMC

References

    1. Minakata K, Schaff HV, Zehr KJ et al. Is the repair of aortic valve regurgitation a safe alternative to valve replacement? J Thorac Cardiovasc Surg 2004;127:645–53. - PubMed
    1. Boodhwani M, de Kerchove L, Glineur D et al. Repair-oriented classification of aortic insufficiency: impact on surgical techniques and clinical outcomes. J Thorac Cardiovasc Surg 2009;137:286–94. - PubMed
    1. Aicher D, Fries R, Rodionycheva S et al. Aortic valve repair leads to a low incidence of valve-related complications. Eur J Cardiothorac Surg 2010;37:127–32. - PubMed
    1. de Meester C, Pasquet A, Gerber BL et al. Valve repair improves the outcome of surgery for chronic severe aortic regurgitation: a propensity score analysis. J Thorac Cardiovasc Surg 2014;148:1913–20. - PubMed
    1. Bierbach BO, Aicher D, Issa OA et al. Aortic root and cusp configuration determine aortic valve function. Eur J Cardio-Thorac Surg 2010;38:400–6. - PubMed

MeSH terms

LinkOut - more resources