Repair of Asymmetric Bicuspid Aortic Valve Using Tricuspidation with CardioCel

Area of Science:

• Cardiovascular Surgery
• Cardiac Valve Repair
• Biomaterials in Medicine

Background:

• Bicuspid aortic valve (AV) disease is a common congenital heart defect.
• Severe asymmetry in bicuspid AVs poses surgical challenges.
• Existing repair techniques may not adequately address highly asymmetrical valves.

Purpose of the Study:

• To present a novel surgical technique for tricuspidation of highly asymmetrical bicuspid aortic valves (AV).
• To evaluate the safety and efficacy of this new AV repair method.

Main Methods:

• Developed a technique involving replacement of the fused cusp in asymmetrical bicuspid AVs with two neo-cusps.
• Fashioned neo-cusps from bovine pericardium and sutured them to the aortic annulus.
• Applied the technique in 15 patients since 2020.

Main Results:

• All 15 patients remain alive post-procedure.
• The repaired aortic valves (AVs) demonstrate well-functioning hemodynamics.
• Patients exhibit no or trivial insufficiency, large orifice areas, and near-physiological transvalvular gradients.

Conclusions:

• This novel tricuspidation technique offers a viable solution for complex asymmetrical bicuspid aortic valves (AV).
• The method shows excellent short-term outcomes, preserving AV function and structure.