Variability of repairable bicuspid aortic valve phenotypes: towards an anatomical and repair-oriented classification

European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery
Laurent de KerchoveHans-Joachim Schäfers

Abstract

The bicuspid aortic valve (BAV) exists in a wide variety of valve phenotypes. The aim of this study was to assess the anatomical characteristics of the different phenotypes and develop a classification system to aid surgical repair. In 178 consecutive patients operated on for aortic insufficiency or aortic dilatation in 2 centres, 11 anatomical parameters of BAV were measured by echocardiography and intraoperatively. All BAV judged potentially repairable were included in the study. Commissural orientation correlated positively with fusion length (R2 = 0.6, P < 0.001) and negatively with non-functional commissure height (R2 = 0.45, P < 0.001). The cohort was divided into 3 groups according to their commissural orientation (type A: symmetrical, 160-180°, n = 73; type B: asymmetrical, 140-159°, n = 74; and type C: very asymmetrical, 120-139°, n = 31). The patterns of cusp fusion, annulus and aortic size were similar among the groups. Fusion length and the geometric height of the cusps decreased from type A to C; non-functional commissure height increased from type A to C (P < 0.05). Patient age increased from type A to type C. Isolated aortic dilatation was more frequent in type A, and severe aortic insufficiency was more frequent...Continue Reading

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Citations

Dec 14, 2019·Current Opinion in Cardiology·Ruggero De PaulisIlaria Chirichilli
Aug 31, 2020·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Lennart FroedeHans-Joachim Schäfers
Sep 17, 2020·JAMA Cardiology·Ulrich SchneiderHans-Joachim Schäfers
Mar 19, 2020·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Koki YokawaKenji Okada
Feb 6, 2020·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Oliver K JawitzG Chad Hughes
Dec 8, 2020·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Johannes PetersenEvaldas Girdauskas
Nov 26, 2019·The Journal of Thoracic and Cardiovascular Surgery·Christopher LauLeonard N Girardi
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·Tirone E David
Jul 1, 2020·The Annals of Thoracic Surgery·Sri Harsha PatlollaJoseph A Dearani
Aug 5, 2020·The Journal of Thoracic and Cardiovascular Surgery·Yuanjia ZhuY Joseph Woo
Mar 25, 2021·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Satoshi ArimuraTakashi Kunihara
Apr 24, 2021·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Marek J JasinskiMarek A Deja
Jul 29, 2021·JTCVS Techniques·Jan M FederspielHans-Joachim Schäfers
Jul 29, 2021·JTCVS Techniques·Yuanjia Zhu, Y Joseph Woo
Jul 29, 2021·JTCVS Techniques·Jama JahanyarLaurent de Kerchove
Jul 23, 2021·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Hector I MichelenaHans-Joachim Schäfers
Jul 3, 2021·Current Cardiology Reports·Karen B AbelnHans-Joachim Schäfers
Jul 23, 2021·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Hector I MichelenaUNKNOWN Endorsed by the Heart Valve Society (HVS), European Association of Cardiovascular Imaging (EACVI), Society of Thoracic Surge
Jul 4, 2021·Seminars in Thoracic and Cardiovascular Surgery·Ilaria ChirichilliRuggero De Paulis
Aug 8, 2021·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Claudia RomagnoniCarlo Antona
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Sep 28, 2021·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Ruggero De Paulis
Jul 22, 2019·The Journal of Thoracic and Cardiovascular Surgery·Stefano MastrobuoniGebrine El Khoury
Aug 20, 2019·The Journal of Thoracic and Cardiovascular Surgery·Luca BottaDavide Pacini

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