EARLY EXPERIENCE IN AORTIC VALVE REPAIR WITH GEOMETRIC RING

Introduction: Aortic valve repair (AVr) with geometric ring aims to restore proper valve function by preserving native leaflets and providing stability to dilated annulus. Methods: We analysed retrospectively all AVr procedures for aortic regurgitation (AR) with geometric ring annuloplasty at our division between January 2022 and August 2024. Results: During the study period, 59 patients underwent AVr using a geometric ring, among them 51 were male and the mean age was 49,3 years (± 17,4). The aortic valve was tricuspid in 28 patients and bicuspid in 31 (52,5%). The bicuspid cohort was younger, with more dilated annulus and left ventricle. 54 patients (91,5%) needed additional cusp repair with either plication of the cusps (79,6%) or shaving (55,9%). In few cases fenestrations closure or cusps reconstruction were necessary. Concomitant surgical procedures were performed in 30 patients (57,6%), including ascending aorta replacement (28,8%) and mitral valve surgery (20,3%). Aortic valve replacement was required in two patients at the time of AVr because of significant residual AR; one was a prior AVr with suture annuloplasty. Mean length–of–stay in ICU and in hospital were 1 and 6.7 days. No significant complications were reported, nor intra–operative and in–hospital mortality. At an average follow-up of 8 months (max 30 months), 86% of the patients had no significant AR, mean aortic gradient was 12.7 mmHg (± 5,6). Only three patients (5,1%) required subsequent aortic valve replacement. Conclusion: Considering our initial learning curve, geometric ring annuloplasty for AR is a safe and reproducible procedure with promising short-term results.