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Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
Published on: December 11, 2017
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Selective sinus replacement for aortic root repair in bicuspid aortopathy.
Paul P Urbanski1, Alaa Atieh1, Lukas Lehmkuhl2
1Department of Cardiovascular Surgery, Cardiovascular Clinic Bad Neustadt, Bad Neustadt, Germany.
The Journal of Thoracic and Cardiovascular Surgery
|April 24, 2022
Summary
Selective sinus replacement (SSR) is an effective valve-sparing technique for bicuspid aortopathy. Aortic cusp repair is crucial for abolishing aortic insufficiency and ensuring long-term valve durability.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Aortic Surgery
Background:
- Bicuspid aortopathy is a complex condition requiring specialized surgical approaches.
- Aortic root remodeling is essential for managing bicuspid aortopathy.
- Selective Sinus Replacement (SSR) offers a valve-sparing option.
Purpose of the Study:
- To evaluate the outcomes of selective sinus replacement (SSR) for aortic root remodeling in patients with bicuspid aortopathy.
- To assess the efficacy and durability of SSR in preserving aortic valve function.
Main Methods:
- Retrospective analysis of 114 patients with bicuspid aortopathy undergoing SSR between 2005 and 2020.
- SSR performed as an isolated procedure or combined with aortic valve repair.
- Aortic annulus diameter was matched to the native size; cusp repair aimed for 180° orientation.
Main Results:
- Isolated SSR was effective for mild aortic insufficiency (AI).
- Combined SSR and valve repair addressed significant AI (≥2+).
- Freedom from relevant valve defect/reoperation was 96% at 5 years, 89% at 10 years, and 82% at 12 years.
Conclusions:
- Patient-tailored SSR is a highly effective and durable valve-sparing treatment for bicuspid aortopathy.
- Aortic cusp repair is critical for successful AI abolition and long-term valve function in bicuspid aortopathy.
