Aortic cusp sizers to establish the functional classification of XXXX : algorithm and midterm outcome of operative repair   .

@entity1 @entity337
OBJECTIVES: Wider adoption of aortic valve repair procedures is held up by the difficulty in recognizing the exact alterations that are responsible for @entity337 . New aortic cusp sizers were developed to assist in aortic valve assessment in the operating theatre. Our objectives were to examine the efficacy of the aortic cusp sizers in establishing the functional classification of @entity337 , and to report the midterm outcome in a group of @entity1 who had undergone aortic valve repair guided by this device. METHODS: A prospective clinical study was performed involving 33 consecutive @entity1 (18 males, age range: 8-74 years) with severe @entity337 (mean severity: 3.4    0.5). The aortic cusp sizers were used as a template to identify existing cusp and root alterations. Consequently, the functional classification of @entity337 was determined, and the appropriate techniques of aortic valve repair were implemented. RESULTS: Aortic valve repair was successful in all @entity1 . Procedures performed were 37 functional aortic annulus corrections, 9 cusp free-edge plications, 2 cusp repairs with autologous pericardium, 9 replacements of the ascending aorta and 2 reimplantation procedures. At a mean follow-up time of 18.3    13.7 months, 1 @entity1 underwent aortic valve replacement for recurrent @entity337 , while aortic valve function remained stable in 32 @entity1 , with @entity337 <1+ in 27 (84.4%) @entity1 and 1-1.5 in 5 (15.6%) @entity1 , and no significant gradients across the aortic valves. CONCLUSIONS: The aortic cusp sizers are valuable in establishing the functional classification of @entity337 , and can guide implementation of aortic valve repair techniques successfully. This approach is analogous to that accredited for the success and wide adoption of mitral valve repair techniques, and is likely to assist in increasing the percentage of aortic valves that are repaired when compared with current practice.
