Aortic root replacement with bicuspid valve reimplantation: Are outcomes and valve durability comparable to those of tricuspid valve reimplantation?

The Journal of Thoracic and Cardiovascular Surgery
Suyog A MokashiLars G Svensson

Abstract

To assess intermediate-term outcomes of aortic root replacement with valve-sparing reimplantation of bicuspid aortic valves (BAV), compared with tricuspid aortic valves (TAV). From January 2002 to July 2017, 92 adults underwent aortic root replacement with BAV reimplantation and 515 with TAV reimplantation at the Cleveland Clinic. Balancing-score matching based on 28 preoperative variables yielded 71 well-matched BAV and TAV pairs (77% of possible pairs) for comparison of postoperative mortality and morbidity, longitudinal echocardiogram data, aortic valve reoperation, and survival. In the BAV group, 1 hospital death occurred (1.1%); mortality among all reimplantations was 0.2%. Among matched patients, procedural morbidity was low and similar between BAV and TAV groups (1 stroke in TAV group; renal failure requiring dialysis, 1 patient each; red cell transfusion, 25% each). Five-year results: Severe aortic regurgitation was present in 7.4% of the BAV group and 2.9% of the TAV group (P = .7); 39% of BAV and 65% of TAV patients had none. Higher mean gradients (10 vs 7.4 mm Hg; P = .001) and left ventricular mass index (111 vs 101 g/m2; P = .5) were present in BAV patients. Freedom from aortic valve reoperation was 94% in the BAV ...Continue Reading

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Citations

Oct 4, 2020·The Journal of Thoracic and Cardiovascular Surgery·Tirone E DavidMyriam Lafreniere-Roula
Apr 14, 2020·The Journal of Thoracic and Cardiovascular Surgery·Christopher Lau, Mario Gaudino
Apr 14, 2020·The Journal of Thoracic and Cardiovascular Surgery·Tirone E David
Jul 29, 2021·JTCVS Techniques·Lars G Svensson
Aug 7, 2021·Current Opinion in Cardiology·Matthew R Schill, Puja Kachroo

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