Valve Repair in Acquired Heart Disease

Abstract

Because there are some relative disadvantages of all cardiac valve replacement devices, there is a continuing interest in repair of diseased valves, rather than replacement. Most of the focus of any discussion of valve repair resides at the atrioventricular valve level, particularly the mitral valve. However, there is some interest in repair of the aortic valve. For example, Duran¹, Carpentier², and Cosgrove et al.³ each have reported small series of suture annuloplasty of the aortic ring to diminish or control aortic incompetence. Basically, an encircling purse-string suture is placed at the base of the aortic cusps and tightened such as to narrow the ventricular aortic junction. Occasionally, a triangular resection of redundant cusp tissue is used. David and Filindel⁴ have described the preservation of the native aortic valve in annular dilatation by scalloping the aortic sinuses and encasing the aortic valve complex in a Dacron tube, and subsequent reattachment of the coronary ostia.