A dysfunctional bicuspid aortic valve (BAV) with associated an aortic root aneurysm
represents complex pathology with multiple options for surgical repair. Traditionally
Bentall aortic root replacement has been the gold standard to ensure a properly functioning
valve and minimize the risk of recurrent root disease. Given the known disadvantages
of prosthetic valve conduits with either a mechanical or bioprosthetic valve in these
often young patients, there has recently been increasing interest and application
of valve-sparing operations in BAV patients with aortic root enlargement. Over the
pasts 15 years, our institution has been able to safely perform valve-sparing root
replacement in select patients with diseased bicuspid aortic valve and root aortopathy.
The outcomes are excellent and long-term follow-up data shows 10-year freedom from
aortic valve or root replacement at 96%. This success can be attributed to appropriate
patient selection, sound operative technique with meticulous post-operative care as
well as a lifetime post-operative follow-up strategy. Here in we describe our operative
technique and key tenets to ensure optimal patient outcomes.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Operative Techniques in Thoracic and Cardiovascular SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
Reference
- Aortopathy in bicuspid aortic valve disease - genes or hemodynamics? or Scylla and Charybdis?.Eur J Cardiothorac Surg. 2011; 39: 803-804
- Congenital bicuspid aortic valve after age 20.Am J Cardiol. 1977; 39: 164-169
- The congenitally bicuspid aortic valve. A study of 85 autopsy cases.Am J Cardiol. 1970; 26: 72-83
- The aortopathy of bicuspid aortic valve disease has distinctive patterns and usually involves the transverse aortic arch.J Thorac Cardiovasc Surg. 2008; 135: 901-907,7.e1-2
- 2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.Circulation. 2021; 143: e72-e227
- Mechanical aortic valve replacement in non-elderly adults: meta-analysis and microsimulation.Eur Heart J. 2017; 38: 3370-3377
- Bioprosthetic aortic valve replacement in nonelderly adults: A systematic review, meta-analysis, microsimulation.Circ Cardiovasc Qual Outcomes. 2019; 12e005481
- Reexamining remodeling.J Thorac Cardiovasc Surg. 2015; 149: S30-S36
- Survival and freedom from aortic valve-related reoperation after valve-sparing aortic root replacement in 1015 patients.Interact Cardiovasc Thorac Surg. 2016; 22: 431-438
- Long-term experience with valve-sparing reimplantation technique for the treatment of aortic aneurysm and aortic regurgitation.J Thorac Cardiovasc Surg. 2019; 158: 14-23
- Valve-sparing root replacement provides excellent midterm outcomes for bicuspid valve aortopathy.Ann Thorac Surg. 2019; 107: 499-504
- Bicuspid aortic valve sparing root replacement.J Card Surg. 2021; 36: 118-123
Article info
Publication history
Published online: October 10, 2022
Publication stage
In Press Journal Pre-ProofFootnotes
Funding: There was no specific funding for this project.
Conflict of interest: The authors have no conflicts of interest or relevant disclosures.
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
