Valsalva prosthesis in aortic valve-sparing operations

a Department of Cardiac Surgery, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy b Department of Cardiology, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy c Cardiac Surgery Intensive Care Unit, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy *Corresponding author: c/o Unità Operativa di Cardiochirurgia, Università degli studi di Bologna, Policlinico S.Orsola-Malpighi, Via Massarenti, 9, 40138 Bologna, Italy Tel.: +39-051-6363361; fax: +39-051-345990. E-mail address : dpacini{at}hotmail.com (D. Pacini). Aortic valve-sparing operations have provided very good clinical outcomes. However, the absence of the sinuses of Valsalva might limit valve durability. The Gelweave Valsalva TM prosthesis, which presents pre-fashioned neo-sinuses, has been designed in order to avoid early leaflets deterioration. We report our results in 63 patients who underwent valve-sparing operations (reimplantation technique) using the Gelweave Valsalva TM graft. The main indication was ascending aorta aneurysm or annuloaortic ectasia, with or without aortic insufficiency. The operation was performed also in cases of Marfan syndrome, Bicuspid Aortic Valve (BAV), and acute Type A dissection. In-hospital mortality was of 4.7%, and two thirds were acute Type A dissection patients ( P =0.01). There were no late deaths. Three years freedom from grade 3–4 AI and freedom from late aortic valve replacement were 91.7±4.3% and 93.8±5.1%, respectively. Aortic valve-sparing operations show good results in patients electively operated for aortic root ectasia. Aortic cusps repair may lead to late failure. Even if the Gelweave Valsalva TM prosthesis is easy to implant and it also reproduces pseudosinuses, a long-term follow up is necessary to determine if this graft may reduce leaflets deterioration. Key Words: Aortic valve insufficiency; Ascending aorta aneurysm; Aortic valve repair