Bicuspidization of the morphological tricuspid aortic valve with ascending aorta replacement in a 5-year-old child

Abstract

Ascending aortic aneurysms are rare in children and may lead to aortic insufficiency, dissection, and/or rupture. We present a 5-year-old child diagnosed with an ascending aortic aneurysm and severe aortic insufficiency, successfully treated with ascending aortic replacement with an aortic valve repair using a bicuspidation technique.

Reoperation for left atrioventricular valve failure in repaired atrioventricular septal defect: Can more valves be preserved in the current era?

“…Valve repair in congenital surgery is now being increasingly performed in the aortic, mitral, and tricuspid positions. [23][24][25][26] The present study shows that in the current era it is increasingly possible to achieve a successful redo-LAVV repair with good early and long-term results.…”

“…Valve repair in congenital surgery is now being increasingly performed in the aortic, mitral, and tricuspid positions …”

Case Report: Occurrence of Severe Thoracic Aortic Aneurysms (Involving the Ascending, Arch, and Descending Segments) as a Result of Fibulin-4 Deficiency: A Rare Pathology With Successful Management

“…While her LV ejection fraction was normal, occurrence of AI causes a significant volume overload on the LV, and can result in progressive LV dilation and failure. Important factors to be considered as an indication for surgery include progressive AI, an aortic size over 5 cm, aneurysm growth rate exceeding 1 cm per year, and a genetic predisposition to early aortic dissection (3,18). There is sparse information about the risk of aortic rupture or dissection in children or young adults, with no clear cut-off point regarding the diameter of aneurysm.…”

“…While the Ross operation might be an alternative for patients with combined ascending aneurysms and severe aortic valve dysfunction, it is often reconsidered because of delayed problems associated with the autograft and the durability of the conduit in the pulmonary position ( 20 ). Bicuspidization technique can be used as a reconstructive approach for the regurgitant morphological tricuspid aortic valve with cusp retraction to avoid complications of anticoagulation ( 3 ). Likewise, aortic root replacement with aortic valve-sparing is attractive for children who have a normally functioning aortic valve because it may avoid anticoagulation ( 23 ).…”

“…Thoracic aortic aneurysms (TAA) are quite atypical within the pediatric population and customarily present in conjunction with antecedent diagnosis of some connective tissue disorder ( 3 ). Patients are primarily classified into two categories, those having aortic root and/or ascending aortic dilatation usually linked with aortic insufficiency (AI), and those having supra-coronary dilatation of the ascending aorta with or without AI ( 3 , 4 ). Management of TAA fundamentally relies on the extent of aortic root involvement, considering the morphology of the aortic valve leaflets.…”