Aortic valve reimplantation by using a Kuban Cuff technique in patients with ascending aorta aneurysm and aortic insufficiency

Aim: This study was designed to evaluate the results of using a new method of aortic valve reimplantation named Kuban Cuff technique, where the key stage of surgery was to create new sinuses of Valsalva. Methods: Analyzed over a period from 2011 to 2015 were the outcomes of treatment of 45 (37 males) patients with various anatomy of the aortic valve (tri/bicuspid ones) and initial pathologies: aneurysms of the root and the ascending aorta, dissection of the ascending aorta, insufficiency of the aortic valve. A detailed description of the surgical technique and the unique device to prepare a vascular graft for reimplantation is given. The mean age of patients was 56.5 years (46.5; 66.5), the average time of cardiopulmonary bypass was 193.6 min (128.9; 2582), the aorta cross-clamping time was 142.6 min (104.5; 180.7), the circulatory arrest time was 28.1 min (13.1; 43.1). Results: Hospital mortality was 2 (4.4%) patients. 3 (6.6%) patients underwent re-sternotomy because of postoperative bleeding. One patient had to undergo a redo (Bentall procedure) at 2 months after discharge from the hospital as a result of acute infective endocarditis of the aortic valve. All patients demonstrated a good function of the aortic valve with regurgitation of 0/1 grade. Prior to discharge, the aortic regurgitation grade was decreased from 2.83±0.44 before surgery to 0.62±0.7 after surgery. The mean follow-up time in 42 patients (93.3%) was 12.3 months (2.68; 21.98). Conclusion: The Kuban Cuff technique fully recreates a close analogue of the natural aortic root, stabilizes the fibrous annulus of the aortic valve, minimizes the risk of bleeding from the anastomosis zone. The technique is simple and reproducible with any type of vascular prostheses and does not take much time.