Cor Vasa 2018, 60(2):e133-e138 | DOI: 10.1016/j.crvasa.2017.07.005

Valve preserving surgery in patients with bicuspid aortic valve

Jiří Ničovský^*, Jiří Ondrášek, Petr Fila, Jan Štěrba, Linda Vetešková, Marek Šebo, Petr Němec

Centrum kardiovaskulární a transplantační chirurgie, Brno, Česká republika

Bicuspid aortic valve can be associated with clinically important aortic regurgitation and dilatation of ascending aorta. Aortic valve repair or valve sparing procedures seem to be optimal therapeutic option how to avoid prosthetic valve-related and anticoagulation-related complications. We have analyzed midterm outcomes of patients after bicuspid aortic valve preserving surgery.

Material and methods: Between January 2008 and December 2015, 91 patients (mean age 40.9 ± 12.2) with bicuspid aortic valve underwent valve preserving surgery for aortic valve regurgitation and/or aortic aneurysm. Urgent procedures and patients of age more than 65 were not included. The cohort of patients was retrospectively divided into two groups. Forty-nine patients underwent aortic valve-sparing procedure with root replacement (group 1). Forty-two patients underwent aortic valve repair without root replacement (group 2). The mean length of follow-up was 57.5 months.

Results: There was no death in connection with aortic valve surgery during follow-up. Three patients from group 2 required in-hospital reoperation for early repair failure. Other seven patients (four from group 1 and three from group 2) were reoperated for recurrent aortic regurgitation during follow-up period. Freedom from aortic valve reoperation at 5 years was 90% in group 1 and 87% in group 2. Freedom from recurrent aortic regurgitation (˃2°) at 5 years was 85% in group 1 and 78% in group 2.

Conclusion: Bicuspid aortic valve repair is a safe procedure, which can be performed with acceptable midterm results. Risk of repair failure depends on preoperative valve morphology and choice of repair technique. Repair technique needs to be tailored to the specific anatomy of the valve and ascending aorta.

Keywords: Aortic regurgitation; Aortic valve repair; Aortic valve-sparing surgery; Bicuspid aortic valve

Received: June 22, 2017; Accepted: July 19, 2017; Published: April 1, 2018  Show citation