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[Reconstruction of the bicuspid aortic valve]
F Langer1, O Wendler, T Graeter
1Abteilung für Thorax- u. Herz-Gefässchirurgie, Universitätskliniken des Saarlandes, Homburg/Saar.
Zeitschrift Fur Kardiologie
|December 1, 2000
Summary
Reconstructing a regurgitant bicuspid aortic valve offers a viable alternative to valve replacement. This valve-sparing aortic replacement technique shows excellent mid-term results, preserving valve function and avoiding reoperation.
Area of Science:
- Cardiovascular Surgery
- Cardiac Valve Repair
- Bicuspid Aortic Valve Disease
Background:
- Bicuspid aortic valve disease is a common congenital heart defect.
- Aortic valve regurgitation in bicuspid valves often necessitates intervention.
- Traditional treatment involves aortic valve replacement, which has limitations.
Purpose of the Study:
- To evaluate the feasibility and mid-term outcomes of reconstructing regurgitant bicuspid aortic valves.
- To assess the efficacy of valve-sparing aortic replacement in patients with concomitant aortic root dilatation.
- To determine freedom from aortic valve regurgitation and reoperation after reconstruction.
Main Methods:
- Retrospective review of 30 patients undergoing bicuspid aortic valve reconstruction between 10/95 and 02/00.
- Valve reconstruction involved plication of the prolapsing leaflet.
- Aortic replacement was performed concomitantly in 23 cases due to aortic root dilatation.
Main Results:
- No peri- or postoperative deaths occurred.
- 100% freedom from aortic valve regurgitation (grade ≥ II) at 48 months.
- 100% freedom from reoperation at 48 months.
Conclusions:
- Reconstruction of regurgitant bicuspid aortic valves is a feasible procedure.
- Valve-sparing aortic replacement combined with valve reconstruction yields encouraging mid-term results.
- This approach offers a durable solution for bicuspid aortic valve regurgitation, even with aortic dilatation.