Document Detail


Preservation of the bicuspid aortic valve.
MedLine Citation:
PMID:  17257919     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Bicuspid anatomy of the aortic valve is a common reason for aortic regurgitation and is associated with aortic dilatation in more than 50% of patients. We have observed different patterns of aortic dilatation and used different approaches preserving the valve. METHODS: Between October 1995 and February 2006, a regurgitant bicuspid valve was repaired in 173 patients. The aorta was normal in 57 patients who underwent isolated repair. Aortic dilatation mainly above commissural level (n = 38) was treated by separate valve repair plus supracommissural aortic replacement. In 78 patients, aortic dilatation involved the root and was treated by root remodeling. RESULTS: Hospital mortality and perioperative morbidity were low in all three groups. Myocardial ischemia was significantly shorter in repair plus aortic replacement than remodeling (p < 0.001). Freedom from aortic regurgitation II or greater at 5 years varied between 91% and 96%. Freedom from reoperation at 5 years was 97% after remodeling, but only 53% after repair plus aortic replacement (p = 0.33). Symmetric prolapse was the most frequent cause for reoperation. CONCLUSIONS: The long-term stability of bicuspid aortic valve repair is excellent in the absence of aortic pathology. In the presence of aortic dilatation, root remodeling leads to equally stable valve durability. In patients with less pronounced root dilatation, separate valve repair plus aortic replacement may be a less complex alternative. Symmetric prolapse should be avoided if the ascending aorta is replaced.
Authors:
Hans-Joachim Schäfers; Diana Aicher; Frank Langer; Henning F Lausberg
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  83     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-01-29     Completed Date:  2007-03-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  S740-5; discussion S785-90     Citation Subset:  AIM; IM    
Affiliation:
Department of Thoracic and Cardiovascular Surgery, University Hospitals of Saarland, Homburg/Saar, Germany. h-j.schaefers@uniklinikum-saarland.de
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Angiography
Aortic Valve / abnormalities*,  radiography,  surgery*,  ultrasonography
Aortic Valve Insufficiency / complications,  etiology*,  surgery*
Aortic Valve Prolapse / etiology,  surgery,  ultrasonography
Blood Vessel Prosthesis Implantation* / adverse effects,  mortality
Cardiac Surgical Procedures* / adverse effects,  mortality
Child
Child, Preschool
Dilatation, Pathologic
Echocardiography
Female
Heart Valve Prosthesis Implantation
Hospital Mortality
Humans
Male
Middle Aged
Reoperation
Retrospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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