Cor Vasa 2010, 52(9):523-530 | DOI: 10.33678/cor.2010.139

Options in reconstructive procedures in patients with a bicuspid aortic valve

Jan Vojáček^1,*, Jan Harrer¹, Jan Dominik¹, Pavel Žáček¹, Jiří Manďák¹, Martin Tuna¹, Miroslav Brtko¹, Jaroslav Hlubocký², Aleš Mokráček³

¹ Kardiochirurgická klinika, Fakultní nemocnice Hradec Králové a Lékařská fakulta v Hradci Králové Univerzity Karlovy v Praze, Kardiocentrum, Fakultní nemocnice Hradec Králové

² II. chirurgická klinika - kardiovaskulární chirurgie, Všeobecná fakultní nemocnice a 1. lékařská fakulta Univerzity Karlovy, Praha

³ Kardiochirurgické oddělení, Nemocnice České Budějovice, a. s., Česká republika

The bicuspid aortic valve is the most common congenital heart disorder potentially resulting, among other things, in the development of aortic valve stenosis or regurgitation. In cardiac surgery, there has been an increasing tendency in the last decade toward aortic valve sparing procedures, even in the presence of the bicuspid aortic valve. The benefits of sparing the native aortic valve include elimination of risks associated with replacing the native valve with a prosthetic one. These are thromboembolic and bleeding complications due to permanent anticoagulation treatment in patients with mechanical valves, the risk of premature degeneration of the biological valve requiring reoperation and the risk of prosthetic valve endocarditis in both types of prosthetic valves.
The authors present a review addressing sparing surgery in the incompetent bicuspid aortic valve. The paper examines the anatomy of the bicuspid aortic valve and indications for surgery, and discusses in detail individual surgical techniques and principles of reconstructive procedures. In the closing section of the paper, the authors provide a clear summary of outcomes of bicuspid aortic valve-sparing procedures including their own experience.

Keywords: Bicuspid aortic valve; Aortic valve-sparing surgery; Aortic regurgitation; Dilatation of the ascending aorta

Published: September 1, 2010  Show citation