Procedure

Repair of aortic valve cusp prolapse

^a Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
^b Department of Cardiovascular and Thoracic Surgery Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Brussels, Belgium

^* Corresponding author: Dr. Munir Boodhwani, Service de Chirurgie Cardiovasculaire et Thoracique, Cliniques Universitaires Saint-Luc UCL 90, Avenue Hippocrate 10, 1200 Brussels, Belgium. Tel.: +32-2-764-6106; fax: +32-2-764-8960. mboodhwani{at}ottawaheart.ca

Aortic valve preservation and repair is emerging as a feasible and attractive alternative to aortic valve replacement in young patients with aortic valve insufficiency. Cusp pathology requiring repair is present in up to 50% of patients undergoing aortic valve repair or valve preserving surgery and may occur in isolation or in conjunction with ascending aortic disease. Diagnosis of cusp prolapse can usually be made on preoperative echocardiography and is confirmed on surgical inspection. Techniques available for the correction of cusp prolapse in a trileaflet aortic valve include free margin plication, and free-margin resuspension. These techniques can be used alone or in combination and both provide stable mid-term results. Choice of technique may, therefore, be tailored to the cusp pathology encountered.

Key Words: Aortic valve • Cusp repair • Surgical technique • Valve repair • Valve sparing