Longer‐term outcomes after bicuspid aortic valve repair in 142 patients. Issue 12 (21st September 2021) - Safari, Mojyan
Abstract: Background: The aim of this study was to evaluate the longer‐term results of bicuspid aortic valve (BAV) repair with or without aortic root replacement. Methods: From 1999 to 2017, 142 patients with or without aortic root dilatation who underwent repair of a regurgitant BAV were included in the study. Ninety‐four patients underwent isolated BAV repair (Group 1; median age 43 years) and 48 patients underwent valve‐sparing aortic root replacement plus BAV repair (aortic valve reimplantation—Group 2; median age 48 years). Median clinical follow‐up time was 5.9 years (range 0.5–15) in Group 1 and 3 years (range 0.5–16) in Group 2, respectively. Results: In‐hospital mortality was 1% in Group 1, and 2% in Group 2 ( p = .6). The 5‐ and 10‐year survival was 93 ± 2.9% and 81 ± 5.8% in Group 1 and 96 ± 3.1% and 96 ± 3.1% in Group 2, respectively ( p = .31). Eleven patients of Group 1 (1.7%/patient‐year) and five patients of Group 2 (2.2%/patient‐year) underwent reoperation of the aortic valve ( p = .5). The 5‐ and 10‐year freedom from reoperation were 93.0 ± 2.1% and 77.1 ± 7.1% in Group 1 and 93.0 ± 5.0% and 76.7 ± 9.6% in Group 2 ( p = .83), respectively. At the latest follow‐up, only two patients of Group 1 and 1 patient of Group 2 had AV regurgitation = 2° ( p = .7). The cumulative linearized incidence of all valve‐related complications (bleeding, stroke, endocarditis, and reoperation) was 2.9%/patient‐year in Group 1% and 4%/patient‐year in Group 2, respectively ( p = .6). Conclusions: Isolated BAV repair and combined aortic valve reimplantation plus BAV repair provide good clinical longer‐term outcomes with relatively low reoperation rate and durable valve function.