Aortic Valve Repair Versus Aortic Valve Replacement
Aortic valve repair has been used successfully to relieve stenosis and avoid early aortic valve insufficiency.43 King et al72 performed mechanical decalcification of the aortic valve on 92 patients. At 5, 10, and 15 years after surgery, the freedom from reoperation rates were 77%, 48%, and 38%, respectively. Although ultrasonic decalcification may adequately relieve stenosis, the unacceptable prevalence of late regurgitation and the prevalence of restenosis have limited the use of this technique.44
Izumoto et al73 repaired the aortic valves of 63 patients who had aortic regurgitation. The 5-year survival rate was 95.1%, and the freedom from reoperation rate was 78%. Izumoto and colleagues concluded that surgery for aortic valve repair is not yet an adequate alternative because of the prevalent need for reoperation. This conclusion was confirmed by Gillinov et al,74 who found that patients operated on for combined aortic and mitral valve repair had a 10-year survival rate of 62% and a freedom from reoperation rate of 65%.
Additional data need to be collected after aortic valve repairs. At this point, the early and long-term effects of aortic valve repairs are unknown.25