Thorac Cardiovasc Surg 2007; 55(6): 351-354
DOI: 10.1055/s-2007-965382
Original Cardiovascular

© Georg Thieme Verlag KG Stuttgart · New York

Impact of Graft Size and Resuspension Level of the Commissures on Aortic Insufficiency after Reimplantation of the Aortic Valve

J. Babin-Ebell1 , F. De Vivo2 , P. R. Vogt3 , P. Roth2
  • 1Department of Cardiac Surgery, University Hospitals of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
  • 2Department of Cardiovascular Surgery, University Hospital Gießen and Marburg, Gießen, Germany
  • 3Department of Cardiac Surgery, Klinik im Park, Zürich, Switzerland
Further Information

Publication History

received January 23, 2007

Publication Date:
24 August 2007 (online)

Abstract

Background: In addition to the size of the graft, the resuspension of the commissures has been described as important for valve function in valve-sparing aortic root replacement procedures. This study describes the influence of a stepwise reduction of the fixation level of the commissures within the graft as well as a stepwise reduction of graft size on valve insufficiency. Method: Porcine aortic valves were reimplanted into a tubular graft and the height of the commissures was reduced in a stepwise manner. In a second series of experiments, the diameter of the grafts was reduced by 30 % and 50 %. Results: A reduction of the commissure heights by 10 % and 20 % caused a significant increase in reflux water. Using the criteria of homograft preparation, a 10 %, but not a 20 %, reduction was tolerated. The coaptation level of the valve became increasingly lower, indicating a higher risk for late valve incompetence. A reduction of the prosthesis diameter by 30 % and 50 % did not result in insufficiency of the valve but it lowered the coaptation level. Conclusion: Resuspension of the commissures within the graft has a more important impact on early failure rates than the choice of graft size.

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PD Dr. Jörg Babin-Ebell

Department of Cardiac Surgery
University Hospitals of Schleswig-Holstein
Campus Lübeck
Ratzeburger Allee 160

23538 Lübeck

Germany

Phone: + 49 45 15 00 21 08

Fax: + 49 45 15 00 20 51

Email: joerg.babin-ebell@web.de