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Successful bicuspid aortic valve repair using external aortic annuloplasty
Hiroki Yamaguchi1, Tatsuya Nakao1, Tasuku Kadowaki1
1Department of Cardiovascular Surgery, New Tokyo Hospital, Chiba, Japan.
The Annals of Thoracic Surgery
|April 4, 2014
Summary
This study presents a novel surgical repair for prolapsed bicuspid aortic valves causing severe aortic insufficiency. The technique effectively restored valve function in a patient with a dilated ventriculoaortic junction.
Area of Science:
- Cardiovascular Surgery
- Cardiac Valve Repair
- Aortic Valve Disease
Background:
- Severe aortic insufficiency often necessitates valve replacement.
- Bicuspid aortic valves (BAV) can prolapse, leading to significant regurgitation.
- Dilated ventriculoaortic junction without root dilation presents a unique surgical challenge.
Observation:
- A 33-year-old male patient presented with severe aortic insufficiency.
- The cause was a prolapsed bicuspid aortic valve with a dilated ventriculoaortic junction (29 mm).
- The aortic root was not dilated.
Findings:
- A combined surgical approach involving external ring annuloplasty with a Gelweave graft and leaflet repair was performed.
- The ventriculoaortic junction was successfully reduced to 22 mm.
- Leaflet repair involved dividing and suturing a raphe, achieving an 8 mm coaptation depth and resulting in trivial aortic insufficiency.
Implications:
- This combined surgical technique offers a viable alternative to valve replacement for specific bicuspid aortic valve pathologies.
- It demonstrates successful repair of a dilated ventriculoaortic junction without root dilation.
- The approach may be suitable for other patients with similar BAV anatomy and aortic insufficiency.
