Preservation of the Bicuspid Aortic Valve

Schäfers, Hans‐Joachim; Aicher, Diana; Langer, Frank; Lausberg, Henning

doi:10.1016/j.athoracsur.2006.11.017

Cited by 102 publications

(81 citation statements)

References 17 publications

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“…It has also been shown that the commissures may be close to a 120°o rientation. 11 Although we have generally been impressed with the reproducibility of the standard repair approach, 12 we have also encountered midterm repair failures related to the geometric alterations associated with aortic replacement. 12 With a follow-up now reaching up to 13 years and a larger patient cohort, we decided to analyze long-term results of BAV repair to determine the predictors of good long-term functional outcome.…”

Section: Clinical Perspective On P 185mentioning

confidence: 99%

“…In the first 36 patients, this was done after cusp repair; in the subsequent 39 patients, this was done before cusp repair to minimize the risk of induced symmetrical prolapse. 12 If dilatation also involved the root (sinus diameter Ͼ43 mm; nϭ122), root remodeling was performed with the technique published previously. 12 In the first 77 individuals, this was done after valve repair; in the subsequent 45 patients, it was done before valve repair.…”

Section: Operative Techniquementioning

confidence: 99%

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Valve Configuration Determines Long-Term Results After Repair of the Bicuspid Aortic Valve

et al. 2011

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Background-Reconstruction of the regurgitant bicuspid aortic valve has been performed for Ͼ10 years, but there is limited information on long-term results. We analyzed our results to determine the predictors of suboptimal outcome. November 1995 and December 2008, 316 patients (age, 49Ϯ14 years; male, 268) underwent reconstruction of a regurgitant bicuspid aortic valve. Intraoperative assessment included extent of fusion, root dimensions, circumferential orientation of the 2 normal commissures (Ͼ160°, Յ160°), and effective height after repair. Cusp pathology was treated by central plication (nϭ277), triangular resection (nϭ138), or pericardial patch (nϭ94). Root dilatation was treated by subcommissural plication (nϭ100), root remodeling (nϭ122), or valve reimplantation (nϭ2). All patients were followed up echocardiographically (cumulative follow-up, 1253 years; mean, 4Ϯ3.1 years). Clinical and morphological parameters were analyzed for correlation with 10-year freedom from reoperation with the Cox proportional hazards model. Hospital mortality was 0.63%; survival was 92% at 10 years. Freedom from reoperation at 5 and 10 years was 88% and 81%; freedom from valve replacement, 95% and 84%. Methods and Results-Between

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Section: Clinical Perspective On P 185mentioning

confidence: 99%

Section: Operative Techniquementioning

confidence: 99%

Valve Configuration Determines Long-Term Results After Repair of the Bicuspid Aortic Valve

et al. 2011

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“…Moreover, there are no clear indications on when repair should be performed and the regarding data demonstrating its safety and durability are limited (Rao et al, 2000;EI Khoury et al, 2006;Aicher et al, 2007;Ashikhmina et al, 2010). In adulthood, the major implication associated with BAV is a tendency toward premature degeneration of the aortic valve with premature presentation of calcific valvular stenosis (Braverman et al, 2005).…”

Section: Aortic Valve Replacementmentioning

confidence: 99%

Surgical Treatment of Bicuspid Aortic Valve Disease

Chen¹,

Lee²

2011

Aortic Valve

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“…Secondly, the FM of chronically dilated roots have often gradually lengthened under the extra strain, thus even the correct STJ diameter may become too small (Figure 16). Symmetric prolapse portends a poor medium term outcome (12,13).…”

Section: Induction Of Symmetric Prolapsementioning

confidence: 99%

Aortic valve sparing root surgery for Marfan syndrome

Matalanis

Perera

2017

Ann. Cardiothorac. Surg.

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Aortic valve sparing root surgery (AVSRS) is a safe and durable alternative for patients with dilated roots or pure aortic regurgitation (AR), which avoids the risks of anticoagulation or valvular degeneration with prosthetic valves. Notwithstanding the theoretical challenges of greater tissue fragility in Marfan syndrome (MFS), AVSRS has been demonstrated to have equal outcomes in this condition as it does in those without MFS. The benefits of retaining the native aortic valve in this generally younger age group extend beyond those of avoiding the inconvenience and complications of prolonged exposure to anticoagulants and include ease of management for future aortic, cardiac and non-cardiac procedures which are the norm for these patients. The essential principles of AVSRS in MFS do not differ from those for the rest of the population.Successful repair and durable valve function depend on a sound understanding of the close interaction between the structure and function of this exquisitely designed piece of engineering. We are fortunate to have numerous tools in our surgical armamentarium to preserve these valves. It is the purpose of this paper to demystify the complex structure-function interactions of the aortic valve, thereby gaining an intuition for AVSRS. We will also elaborate on specific technical details of established techniques that we have found successful in preserving the normal function of these valves in the long term.

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Preservation of the Bicuspid Aortic Valve

Cited by 102 publications

References 17 publications

Valve Configuration Determines Long-Term Results After Repair of the Bicuspid Aortic Valve

Valve Configuration Determines Long-Term Results After Repair of the Bicuspid Aortic Valve

Surgical Treatment of Bicuspid Aortic Valve Disease

Aortic valve sparing root surgery for Marfan syndrome

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