Aortic Valve Repair for Rheumatic Aortic Valve Disease

Background The aim of this study is to assess the long-term results of aortic valve repair in patients with rheumatic aortic valve disease. Methods From April 1991 through December 2003, 61 patients with rheumatic aortic valve disease underwent aortic valve repair. Mean age was 23.7 ± 9.3 years (range, 6 to 53 years). Thirty-nine (63.9%) patients were in New York Heart Association functional class III. Reparative procedures included cuspal thinning (n = 59), commissurotomy (n = 45), subcommissural annuloplasty (n = 24), commissural plication (n = 12), perforation closure using pericardium (n = 2), and decalcification of cusps (n = 2). Associated procedures included mitral valve repair (n = 36) and tricuspid valve repair with mitral valve repair (n = 5). Results Early mortality was 4.9% (3 patients). Mean follow-up was 93.8 ± 46.4 months (range, 6 to 160 months, median, 103 months). Forty-six survivors (65%) had no or trivial or mild aortic regurgitation. Four patients required reoperation for valve dysfunction. There were no late deaths. Actuarial and reoperation-free survival, at 160 months, was 95.2% ± 2.8% and 85.4% ± 6.7%, respectively. Freedom from significant aortic stenosis or regurgitation was 52.4% ± 16.9%. Conclusions Aortic valve repair in patients with rheumatic aortic valve disease is feasible and yields gratifying long-term results.