Fate of bicuspid aortic valves in patients undergoing aortic root repair or replacement for aortic root enlargement

Gruschen R. Veldtman, Heidi M. Connolly, Thomas A. Orszulak, Joseph A. Dearani, Hartzell V Schaff

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

OBJECTIVE: To better understand the outcome of the bicuspid aortic valve (BAV) after valve-sparing root replacement, we evaluated BAV function after its preservation at the time of the ascending aorta (AA) repair. PATIENTS AND METHODS: From January 1, 1994, through March 31, 2002, BAVs were preserved during repair of AA aneurysms in 21 patients (mean ± SD age, 45±12 years; 13 males). We reviewed the clinical and surgical reconls of these patients for baseline characteristics, operative procedures, and data at latest follow-up. RESULTS: The primary indication for operation was AA enlargement (median diameter, 55 mm; range, 43-65 mm) in 18 patients and severe aortic regurgitation (AR) in 3 patients. Preoperatively, the BAV exhibited mild or moderate stenosis In 5 patients (mean gradient, 25 mm Hg; range, 19-34 mm Hg), moderate AR in 2, and severe AR in 3. Aortic valve repair was performed in 11 patients. Seventeen patients had excision and graft replacement of the enlarged AA, and 4 patients had primary AA repair. There were no perioperative deaths. Moderate or severe AR was relieved in all patients early postoperatively and during follow-up (median, 2.5 years; maximum, 7.6 years). One patient required aortic valve replacement at 4.8 years for AR. An additional patient had recurrent, severe AR but was asymptomatic and has not undergone reoperetion. CONCLUSION: Repair of diseased BAVs or preservation of functionally normal BAVs during surgery for AA aneurysms has a low perioperative risk, and early results are encouraging. Additional observation Is necessary to determine whether this strategy has real advantages over early aortic valve replacement.

Original languageEnglish (US)
Pages (from-to)322-326
Number of pages5
JournalMayo Clinic Proceedings
Volume81
Issue number3
DOIs
StatePublished - 2006

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Aortic Valve Insufficiency
Aorta
Aortic Valve
Aneurysm
Bicuspid Aortic Valve
Operative Surgical Procedures
Pathologic Constriction
Observation
Transplants

ASJC Scopus subject areas

  • Medicine(all)

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Fate of bicuspid aortic valves in patients undergoing aortic root repair or replacement for aortic root enlargement. / Veldtman, Gruschen R.; Connolly, Heidi M.; Orszulak, Thomas A.; Dearani, Joseph A.; Schaff, Hartzell V.

In: Mayo Clinic Proceedings, Vol. 81, No. 3, 2006, p. 322-326.

Research output: Contribution to journalArticle

Veldtman, Gruschen R. ; Connolly, Heidi M. ; Orszulak, Thomas A. ; Dearani, Joseph A. ; Schaff, Hartzell V. / Fate of bicuspid aortic valves in patients undergoing aortic root repair or replacement for aortic root enlargement. In: Mayo Clinic Proceedings. 2006 ; Vol. 81, No. 3. pp. 322-326.
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