Bicuspid aortic valve repair: outcomes after 17 years of experience. (23rd April 2021)

• Record Type: Journal Article
• Authors: Jasinski, Marek J; Kosiorowska, Kinga; Gocol, Radoslaw; Jasinski, Jakub; Nowicki, Rafal; Bielicki, Grzegorz; Berezowski, Mikolaj; Przybylski, Roman; Obremska, Marta; Lukaszewski, Marceli; Larysz, Anna; Kansy, Andrzej; Deja, Marek A
• Is Part Of: European journal of cardio-thoracic surgery. Volume 60:Number 5(2021)
• Page Start: 1053
• Page End: 1061
• Publication Date: 2021-04-23
• Subjects: Aortic valve repair -- Bicuspid aortic valve -- Repair failure risk factors; Heart -- Surgery -- Periodicals; Chest -- Surgery -- Periodicals; 617.54
• DOI: 10.1093/ejcts/ezab176
• Languages: English
• ISSNs: 1010-7940

Abstract

Abstract: : OBJECTIVES: This study presents the results of 17 years of experience with bicuspid aortic valve (BAV) repair and the analysis of factors associated with repair failure and early echocardiographic outcome. METHODS: Between 2003 and 2020, a total of 206 patients [mean age: 44.5 ± 15.2 years; 152 males (74%)] with BAV insufficiency with or without aortic dilatation underwent elective aortic valve repair performed by a single surgeon with a mean follow-up of 5 ± 3.5 years. The transthoracic echocardiography examinations were reported. RESULTS: There were no deaths during the hospital stay, and all but 1 patient survived the follow-up period (99.5%). Overall, 10 patients (5%) developed severe insufficiency and 2 (1%) developed aortic dilatation requiring reoperation. Freedom from reoperation at 7 years reached 91.8%. Type 2 BAV configuration [hazard ratio (HR) 3.9; 95% confidence interval (CI): 1.01–60; P = 0.049], no sinotubular junction remodelling (HR 7; 95% CI: 1.7–23; P = 0.005), no circumferential annuloplasty (HR 3.9; 95% CI: 1.01–64; P = 0.047) and leaflet resection (HR 5.7; 95% CI 1.2–13. P = 0.017) have been identified as a risk factor of redo operation. Parameters of the postoperative left ventricle reverse remodelling improved significantly early after the operation and later at 2 years evaluation. CONCLUSIONS: The repair of BAV offers good short- and mid-term results providing a significant reverse left ventricular remodelling. Type 0 BAV preoperative configuration, circumferential annuloplasty and sinotubular junction remodelling are associated with better repair durability.