Early Outcomes Using the Florida Sleeve Repair for Correction of Aortic Insufficiency due to Root Aneurysms

Background The Florida sleeve procedure is a simplified valve-sparing technique for repair of functional type I aortic insufficiency associated with root aneurysms. Midterm outcomes are reported, including standard echocardiographic measurements. Methods The study included all patients undergoing the Florida sleeve procedure who had at least 2 years of postoperative echocardiographic follow-up. Data were acquired preoperatively and postoperatively at 1 week and 1, 2, and 3 years. Measurements analyzed included left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), and degree of aortic insufficiency. Results Complete echocardiographic data for a mean 32 ± 6.3 months after repair were available for 18 patients. Mean LVEDD decreased from 51.6 ± 7.4 to 49.7 ± 6.3 mm at 1 week ( p = 0.05) and 47.1 ± 6.3 mm at 1 year ( p = 0.008), and remained unchanged at 47.2 ± 6.6 and 47.1 ± 5.0 mm at 2 and 3 years. Mean LVESD decreased from 35.2 ± 7.6 to 32.9 ± 7.0 mm at 1 week ( p = 0.002) and 30.7 ± 5.6 mm at 1 year ( p ω 0.001), and remained unchanged at 30.9 ± 6.2 and 31.7 ± 4.9 mm after 2 and 3 years. The mean grade of aortic insufficiency decreased from 2.61 ± 0.78 to 1.39 ± 0.85 mm at 1 week ( p ω 0.001) and remained 1.39 ± 0.84 mm at 1 year. Aortic insufficiency increased to 1.72 ± 0.89 ( p = 0.03) at 2 years and decreased to 1.67 ± 0.50 ( p = 0.59, from 1 week postoperatively) at 3 years. Conclusions The sustained reduction of left ventricular dimensions 3 years after operation suggests the Florida sleeve procedure is a durable valve repair. A minor increase in the degree of aortic insufficiency warrants close follow-up, but the absence of an increase of LVEDD supports continued use of the procedure in closely studied series.