Fate of preserved bicuspid valves at time of ascending aortic aneurysmectomy.

Authors:
Mohammad A Zafar, MBBS
Mohammad A Zafar, MBBS
Aortic Institute at Yale-New Haven Hospital
Research Director
New Haven, CT | United States

J Card Surg 2019 May 21;34(5):318-322. Epub 2019 Mar 21.

Aortic Institute at Yale-New Haven Hospital, Yale University School of Medicine, New Haven, Connecticut.

Background: The fate of the spared bicuspid aortic valve in patients undergoing ascending aortic aneurysm surgery is relatively unknown. Our institutional policy has been to replace all aortic valves with significant abnormalities, as evidenced by intraoperative transesophageal echocardiography or direct visual inspection. In this study, we elaborate our experience regarding the long-term fate of preserved bicuspid aortic valves after ascending aortic aneurysm extirpation.

Materials And Methods: From 2000 to 2018, 407 consecutive ascending aortic aneurysm patients with concomitant bicuspid aortic valves underwent surgery by a single surgeon at our institution. Among these, 23 (5.65%) patients did not have their valve replaced, forming the study group. Postoperative and preoperative echocardiograms were compared to determine changes in valve function.

Results: Follow-up was complete in 100% of patients. The average time between preoperative and postoperative echocardiograms was 4.50 ± 4.09 years (0.19-15.63). Aortic stenosis or regurgitation changed from none to mild in 5 (21.7%) of patients, with an average echocardiographic interval follow-up of 3.08 years, and from none to severe in 2 (8.7%), with an interval of 11.7 years. One patient required reoperation, including aortic valve replacement, during follow-up.

Conclusion: Bicuspid aortic valves free of aortic stenosis or insufficiency before surgery and "healthy" appearing at surgery can safely be preserved.

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Source
http://dx.doi.org/10.1111/jocs.14024DOI Listing
May 2019
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References

(Supplied by CrossRef)
Management of bicuspid aortic valve with or without involvement of ascending aorta and aortic root
Neragi‐Miandoab S et al.
J Cardiovasc Surg 2014
Results of valve preservation and repair for bicuspid aortic valve insufficiency
Alsoufi B et al.
J Heart Valve Dis 2005

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