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. 2024 Jan 6;11(1):17.
doi: 10.3390/jcdd11010017.

Aortic Valve Repair with External Annuloplasty in Bicuspid versus Tricuspid Aortic Valve Patients

Davor Baric  1 , Nikola Sliskovic  1 , Gloria Sestan  1 , Savica Gjorgjievska  1 , Daniel Unic  1 , Marko Kusurin  1 , Josip Varvodic  1 , Zrinka Safaric Oremus  2 , Ivana Jurin  3 , Nikola Bulj  4 , Dubravka Susnjar  1 , Igor Rudez  1
Affiliations

Aortic Valve Repair with External Annuloplasty in Bicuspid versus Tricuspid Aortic Valve Patients

Davor Baric et al. J Cardiovasc Dev Dis. .

Abstract

Surgical repair for regurgitant bicuspid aortic valve (BAV) is promising but underutilized due to perceived complexities and lack of long-term data. This study evaluated the efficacy of valve-sparing root remodeling (VSRR) or isolated valve repair combined with calibrated external ring annuloplasty in BAV versus tricuspid aortic valve (TAV) patients. All patients operated on for aortic regurgitation and/or aneurysm at our institution between 2014 and 2022 were included and entered into the Aortic Valve Insufficiency and ascending aorta Aneurysm InternATiOnal Registry (AVIATOR). Patients with successful repair at index surgery (100% in the BAV group, 93% in the TAV group, p = 0.044) were included in a systemic follow-up with echocardiography at regular intervals. Among 132 patients, 58 were in the BAV (44%) and 74 in the TAV group (56%). There were no inter-group differences in preoperative patient characteristics, except BAV patients being significantly younger (47 ± 18 y vs. 60 ± 14 y, p < 0.001) and having narrower aortic roots at the level of sinuses (41 ± 6 mm vs. 46 ± 13 mm, p < 0.001) and sinotubular junctions (39 ± 10 mm vs. 42 ± 11, p = 0.032). No perioperative deaths were recorded. At four years, there was no significant difference in terms of overall survival (96.3% BAV vs. 97.2% TAV, p = 0.373), freedom from valve reintervention (85.2% BAV vs. 93.4% TAV, p = 0.905), and freedom from severe aortic regurgitation (94.1% BAV vs. 82.9% TAV, p = 0.222). Surgical repair of BAV combined with extra-aortic annuloplasty can be performed with low perioperative morbidity and mortality and excellent mid-term results which are comparable to TAV repair.

Keywords: AVIATOR registry; aortic valve repair; bicuspid aortic valve (BAV); external annuloplasty; tricuspid aortic valve (TAV); valve-sparing root remodeling (VSRR).

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Overall survival.
Figure 2
Figure 2
Freedom from AV reintervention.
Figure 3
Figure 3
Freedom from aortic regurgitation > 2+.
See this image and copyright information in PMC

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