Repair of insufficient bicuspid aortic valves

Charles D. Fraser, Nan Wang, Roger B.B. Mee, Bruce W. Lytle, Patrick M. McCarthy, Shelly K. Sapp, Eliot R. Rosenkranz, Delos M. Cosgrove

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Abstract

A technique for the repair of bicuspid aortic valves that includes resection of the flail segment of the prolapsing leaflet, annuloplasty, and resection of the raphe, when present, has been reported. To assess the efficacy of this technique in the repair of insufficient bicuspid aortic valves, the results in 72 consecutive patients were assessed. The mean age of the patients was 39 ± 11 years; 94% were male. Fifty-six patients (78%) underwent isolated aortic valve repair, 9 (12.5%) underwent aortic and mitral valve repair, and 7 (9.7%) had other associated procedures. All patients underwent leaflet resection, including 35 (48%) at the raphe. The mean aortic occlusion time was 39 ± 12 minutes. There were no operative deaths. The severity of aortic insufficiency, as assessed by Doppler echocardiography (graded from 0 to 4) preoperativety and intraoperatively and at late follow-up, was 3.6 ± 0.6, 0.4 ± 0.4, and 0.9 ± 0.8, respectively, with a p value of < 0.0001 for the latter two values versus the preoperative one. There have been no postoperative deaths. Patients did not receive anticoagulation treatment and there were no strokes or episodes of endocarditis. Six patients have required reoperation; 3 underwent repeat repair. The Kaplan-Meier freedom from aortic valve reoperation probabilities at 12 and 24 months were 94% and 89.5%, respectively. We conclude that valvuloplasty for insufficient bicuspid aortic valves is technically safe, is associated with a low incidence of recurrent insufficiency, and has been associated with no other valve-related complications.

Original languageEnglish (US)
Pages (from-to)386-390
Number of pages5
JournalThe Annals of Thoracic Surgery
Volume58
Issue number2
DOIs
StatePublished - Aug 1994

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ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Fraser, C. D., Wang, N., Mee, R. B. B., Lytle, B. W., McCarthy, P. M., Sapp, S. K., Rosenkranz, E. R., & Cosgrove, D. M. (1994). Repair of insufficient bicuspid aortic valves. The Annals of Thoracic Surgery, 58(2), 386-390. https://doi.org/10.1016/0003-4975(94)92212-8