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Related Concept Videos

Mitral Stenosis III: Medical Management01:26

Mitral Stenosis III: Medical Management

Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
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IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
Aortic Regurgitation III: Medical Management01:25

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Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...

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Surgical Aortic Valve Replacement For Bicuspid And Tricuspid Valve Disease: 7-Year Outcomes In >1100 Patients.

Louis Labrousse1, Michael G Moront2, Francois Dagenais3

  • 1Medico-Surgical Department of Valvulopathies, Bordeaux Heart University Hospital, Bordeaux-Pessac, France. louis.labrousse@chu-bordeaux.fr.

Portuguese Journal of Cardiac Thoracic and Vascular Surgery
|May 6, 2025
PubMed
Summary

Surgical aortic valve replacement with the Avalus bioprosthesis showed excellent 7-year outcomes for patients with bicuspid aortic valves. This procedure demonstrated favorable results, including similar hemodynamic performance and low reintervention rates compared to tricuspid valves.

Keywords:
Surgical aortic valve replacementaortic regurgitationaortic stenosisaortic valve surgerycongenital bicuspid aortic valvetricuspid aortic valve

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Area of Science:

  • Cardiovascular Surgery
  • Bioprosthetic Valves
  • Aortic Valve Disease

Background:

  • Bicuspid aortic valve (BAV) affects 0.5-2% of the population, often presenting in younger, lower-risk individuals.
  • Uncertainty exists regarding optimal aortic valve replacement (AVR) strategies for BAV patients.
  • Evaluating newer bioprostheses in this population is crucial for informed clinical decision-making.

Purpose of the Study:

  • To compare 7-year clinical outcomes of surgical AVR (SAVR) using the Avalus bioprosthesis in patients with congenital bicuspid versus tricuspid aortic valves.
  • To assess the performance and safety of the Avalus bioprosthesis across different aortic valve morphologies.

Main Methods:

  • A prospective, non-randomized study included 1132 patients undergoing SAVR with the Avalus bioprosthesis.
  • Patients were stratified into bicuspid (n=339) and tricuspid (n=775) aortic valve groups.
  • Kaplan-Meier analyses and multivariable Cox models with propensity score adjustments were used to evaluate outcomes over 7 years.

Main Results:

  • At 7 years, the bicuspid cohort had lower mortality (8.9% vs. 21.3%) but higher non-structural valve dysfunction (2.9% vs. 0.6%) compared to the tricuspid cohort.
  • Hemodynamic parameters, including effective orifice area and mean aortic gradient, were similar between groups.
  • Reintervention rates were low and comparable in both bicuspid (6.8%) and tricuspid (5.4%) cohorts.

Conclusions:

  • SAVR with the Avalus bioprosthesis provides excellent 7-year outcomes for both bicuspid and tricuspid aortic valve patients.
  • The bioprosthesis demonstrates similar hemodynamic performance and low reintervention rates across valve morphologies.
  • These findings support the Avalus bioprosthesis as a safe and effective option for AVR in patients with bicuspid aortic valves.