Aortic root surgery : echo analysis repair versus replacement

Chronic aortic regurgitation (AR) sets in motion numerous compensatory mechanisms for left ventricle (LV) to be able to maintain normal ejection fraction (EF), regardless of chronic volume and pressure overload. With long standing AR compensatory mechanism eventually fail and EF decreases. The survival prognosis is poor once symptoms develop. That is why current guidelines recommend surgical intervention in case of symptoms, EF≤50% or left ventricular end-diastolic diameter (LVEDD) > 70mm or left ventricular end-systolic diameter (LVESD) > 50mm. Aortic valve replacement (AVR) is an established treatment for patients with AR. In the past 20 years numerous repair techniques for diseased aortic valves (AV) have been developed with the aim to be able to treat AR without subjecting patient to possible complications connected with mechanical or bioprosthetic valve implantation. Promising results of aortic valve repair (AVRep) surgeries in terms of overall survival, freedom from re-operation and valve related complications have been documented. LV reverse remodeling has been reported both after AVR and AVRep. This retrospective study investigated and compared changes in LV dimension (LVEDD) and function (LVEF) between 32 patients who underwent AVR and 25 who underwent AVRep for treatment of AR. Statistically significant (p