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Unicuspid Aortic Valve in Patients Undergoing the Ross Procedure
Jan Gofus1, Petr Fila2, Martin Vobornik1
1Department of Cardiac Surgery, Charles University, Faculty of Medicine and University Hospital in Hradec Kralove, Hradec Kralove, Czech Republic.
The Annals of Thoracic Surgery
|April 17, 2022
Summary
Unicuspid aortic valve (UAV) patients undergoing the Ross procedure show distinct pathology but have similar midterm reoperation and aortic regurgitation risks compared to bicuspid (BAV) and tricuspid (TAV) valves. UAV is acceptable for the Ross procedure.
Area of Science:
- Cardiovascular Surgery
- Congenital Heart Disease
- Aortic Valve Disease
Background:
- The unicuspid aortic valve (UAV) is underreported in the literature regarding its outcomes after the Ross procedure.
- This study compares UAV outcomes with bicuspid aortic valve (BAV) and tricuspid aortic valve (TAV) in a Ross procedure cohort.
Purpose of the Study:
- To evaluate the prevalence and midterm outcomes of UAV in patients undergoing the Ross procedure.
- To compare UAV outcomes with BAV and TAV regarding reoperation and aortic regurgitation.
Main Methods:
- Retrospective observational study of 286 patients undergoing the Ross procedure (2009-2020).
- Primary endpoints: midterm autograft reoperation risk and onset of moderate aortic regurgitation.
- Secondary endpoint: comparison of perioperative outcomes.
Main Results:
- UAV patients (39%) were younger and had larger aortic root dimensions compared to BAV (52%) and TAV (9%) groups.
- Midterm risks of reoperation (P=.86) and aortic regurgitation (P=.75) were comparable across all valve types.
- No significant differences in perioperative outcomes were observed.
Conclusions:
- UAV presents unique hemodynamic pathology and aortopathy but is not associated with increased midterm reoperation or aortic regurgitation risk after the Ross procedure.
- UAV is considered an acceptable indication for the Ross procedure.
- Further research into UAV-specific aortopathy is warranted.
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