Aortic valve repair techniques such as free margin plication and resuspension provide stable mid-term results for young patients with aortic valve insufficiency and cusp prolapse.
Supports repair in select young patients with cusp prolapse; hypothesis-generating and should not yet change practice.
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.
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Boodhwani et al. (2009) studied this question.
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