Objective: Bicuspid aortic valve (BAV) is generally considered to be a contraindication to sutureless aortic valve replacement (AVR). The aim of this study was to evaluate the feasibility and perioperative outcomes of this technique in patients with BAV.Methods: From June 2011 to January 2014, a total of 25 patients who underwent sutureless AVR had documented BAV. Thirteen patients (52%) had median sternotomy, and 12 patients (48%) a minimally invasive approach.
Results:The study population included 17 (68%) men with a median age of 77.8 AE 5.4 years. The mean EuroSCORE II was 3.4% AE 2.6%. Concomitant procedures included coronary artery bypass grafting in 8 patients (32%), 2 AVRs (8%), 1 mitral valve repair (4%), 1 septal myomectomy (4%), and 1 atrial septal defect closure (4%). The mean transaortic valve gradient decreased from 49.4 AE 15.7, to 14.5 AE 5.4 mm Hg postoperatively. The mean aortic valve area increased from 0.78 AE 0.18, to 1.75 AE 0.43 cm 2 postoperatively. Five patients (20%) suffered from atrioventricular block that required permanent pacemaker implantation. Two patients (8%) suffered a stroke. No major paravalvular leakage occurred, and no postoperative valve migration. In-hospital mortality occurred in 1 patient (4%). The mean intensive care unit length of stay was 3 AE 2 days postoperatively.Conclusions: This study demonstrates that a sutureless aortic valve can be deployed in patients with BAV without increasing the risk of paravalvular leakage. BAV should not be considered a contraindication to sutureless AVR.
Within a matter of 48 hours, the promotion of the article entitled "Prevalence of unprofessional social media content among young vascular surgeons," aptly demonstrated the power of social media and the dangers of unconscious bias as it spread across Twitter with the #MedBikini tag. In response, vascular surgeons from around the world have come together in a call to action to address the article and highlight the misogynistic, racist, and oppressive issues facing young surgeons today. We, as female vascular surgery trainees, would like to make our own call to action. The publication of this article (now appropriately retracted) has encouraged important dialogue among female vascular surgeons, male colleagues who support #HeforShe initiatives, other disadvantaged and marginalized groups in surgery, and the future generation of surgeons who will pave the path forward. We have converged to discuss the current climate of our specialty and have determined that now is an opportunity for change.It is essential that we pursue ethics, as well as excellence, in surgical practice and research. The inherent conscious and unconscious biases, poor study design, and unethical data collection methods within the article have demonstrated a critical flaw within the editorial process of the Journal of Vascular Surgery (JVS). We are disappointed to find ourselves represented by the article. The publication was both tone deaf toward, and discriminatory against, us as professionals, trainees, and women. As vascular surgeons, we must hold ourselves to a higher standard. Our call to action for the JVS includes the following:1. Re-examine the review process for publication of ethical abstracts from regional and national meetings and manuscripts, and provide training in ethical research for all editors and reviewers.
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