Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Nov;37(11):3469-3476.
doi: 10.1111/jocs.16953. Epub 2022 Sep 19.

Fifteen-year experience with the Tirone David procedure in bicuspid aortic valve: A safe option

Charline Pujos  1 , Nicolas D'ostrevy  1 , Mehdi Farhat  1 , Etienne Geoffroy  1 , Nicolas Dauphin  1 , Adama Sawadogo  1 , Céline Lambert  2 , Lionel Camilleri  1
Affiliations

Fifteen-year experience with the Tirone David procedure in bicuspid aortic valve: A safe option

Charline Pujos et al. J Card Surg. 2022 Nov.

Abstract

Background: We evaluated short and midterm outcomes with use of aortic valve-sparing root replacement to treat bicuspid aortic valves (BAVs).

Methods: From December 2007 to January 2022, all patients with BAVs who underwent aortic root replacement using Tirone's procedure were included. This study based on department database information for retrospective and follow-up data.

Results: Among 51 adults undergoing aortic root replacement using Tirone's procedure, the mean age was 47.4 ± 12.5 years, and most were men (92.2%). Three presented with a dysmorphic syndrome and one had Marfan's syndrome. All patients were alive at 30 days, and as of January 2022, 45 were alive, two were lost to follow-up, and there were four noncardiac deaths. Two patients had infectious endocarditis and needed a Bentall's procedure. One patient had a double biologic valve replacement in the context of severe mitral insufficiency with moderate aortic stenosis at 4.5 years postprocedure. Echocardiographic follow-up showed a left ventricular ejection fraction of 63 ± 7% (n = 36), Vmax 2 ± 0.6 m/s (n = 17), and a mean gradient of 9.4 ± 5.4 mmHg (n = 27). No patients had grade 3 or 4 aortic regurgitation, one patient had grade 2, and four had grade 1.

Conclusion: Tirone's procedure is an option for BAV surgery, with good safety and outcomes, especially in younger patients.

Keywords: AVSRR; Tirone procedure; aortic aneurysm; aortic insufficiency; bicuspid aortic valve.

PubMed Disclaimer

References

REFERENCES

    1. Roberts WC. The congenitally bicuspid aortic valve: a study of 85 autopsy cases. Am J Cardiol. 1970;26(1):72-83.
    1. Borger MA, David TE. Management of the valve and ascending aorta in adults with bicuspid aortic valve disease. Semin Thorac Cardiovasc Surg. 2005;17(2):143-147.
    1. Ehrlich T, de Kerchove L, Vojacek J, et al. State-of-the art bicuspid aortic valve repair in 2020. Prog Cardiovasc Dis. 2020;63(4):457-464.
    1. Bentall H, De Bono A. A technique for complete replacement of the ascending aorta. Thorax. 1968;23(4):338-339.
    1. Aicher D, Langer F, Kissinger A, Lausberg H, Fries R, Schäfers H-J. Valve-sparing aortic root replacement in bicuspid aortic valves: a reasonable option? J Thorac Cardiovasc Surg. 2004;128(5):662-668.

Substances

LinkOut - more resources