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Journal of Medical Ultrasonics

, Volume 46, Issue 1, pp 51–62 | Cite as

Aortic valve repair for aortic regurgitation and preoperative echocardiographic assessment

  • Takashi KuniharaEmail author
Review Article
  • 111 Downloads

Abstract

Aortic valvuloplasty (AVP) has been performed less frequently than mitral valvuloplasty. The survival benefit of AVP over replacement has been demonstrated. Therefore, standardization of AVP is crucial for its widespread adoption. The hemodynamic advantage of AVP of preserving the native aortic valve may be one reason for the survival benefit. Recent guidelines still recommend AVP in selected cases compared with the less restricted recommendation for mitral valvuloplasty, although recent studies have proposed earlier indication for surgical intervention. Indication for aortic root replacement is also still conservative, especially in Japan. However, more liberal root replacement should be recommended for better repair when AVP is indicated. Theoretically, all aortic regurgitation lesions can be repaired with acceptable durability. However, restricted cusp should be extended by a pericardial patch, which itself has emerged as a risk of recurrence. Therefore, indications for aortic regurgitation for type III lesions should be determined carefully. Special consideration is crucial for bicuspid aortic valve repair; prevention of postoperative stenosis is especially important. Arrangement of the commissure position is the most important consideration for this purpose, although it remains controversial. Therefore, detailed diagnosis is important in planning AVP, and echocardiography plays a key role in this process.

Keywords

Aortic valve repair Valve-preserving root replacement Echocardiography Surgical indication Operative technique 

Notes

Acknowledgements

The author would like to thank Dr. Miura, Shizuoka City Shizuoka Hospital, and Dr. Hama, Saku Central Hospital Advanced Care Center, for sharing intraoperative and echocardiographic findings.

Compliance with ethical standards

Conflict of interest

The author declares that there are no conflicts of interest related to this study.

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Copyright information

© The Japan Society of Ultrasonics in Medicine 2018

Authors and Affiliations

  1. 1.Department of Cardiac SurgeryJikei University School of MedicineTokyoJapan

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