Survival and reoperation risk following bicuspid aortic valve-sparing root replacement

Basar Sareyyupoglu, Rakesh M. Suri, Hartzell V Schaff, Joseph A. Dearani, Richard C. Daly, Thomas A. Orszulak, Thoralf M. Sundt

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Background and aim of the study: The mid-term out-come of aortic valve-sparing root replacement, reim-planting native bicuspid versus tricuspid aortic valves, is unclear. Methods: The records of 84 consecutive patients (66 men, 18 women; mean age 46.6 years) who had undergone aortic valve-sparing root replacement using the reimplantation technique between January 1997 and July 2006, were reviewed. Among the patients, 26 (31%) had Marfan syndrome and 14 (17%) had a bicuspid aortic valve. The mean follow up period was 4.1 years. Results: There were three early deaths (4%) and five late deaths (6%). Late survival (>30 days) at five and eight years was 95% and 88%, respectively. The pres-ence of significant coronary artery disease (p = 0.001), a lower preoperative ejection fraction (p = 0.03) and older age (p = 0.04) were the only univariate predic-tors of death. Freedom from moderate-severe or severe (grade 3 or 4) aortic valve regurgitation at one and five years was 91% and 77%, respectively. Ten patients (12%) required aortic valve reoperation at a mean of 3.4 years after surgery (3/14 bicuspid, 7/70 tricuspid); however, only one reoperation was required among patients undergoing the initial sur-gery after the year 2000. Freedom from aortic valve reoperation at one and five years was 95% and 83%, respectively. The predischarge degree of aortic valve regurgitation was the sole univariate factor associat-ed with aortic valve reoperation (p = 0.008). Bicuspid valve morphology was not a predictor of either recur-rent aortic valve regurgitation, nor of aortic valve reoperation. Conclusion: Bicuspid aortic valves may be safely spared by reimplantation during replacement of the aortic root, with similar mid-term durability as for tricuspid aortic valves.

Original languageEnglish (US)
Pages (from-to)1-8
Number of pages8
JournalJournal of Heart Valve Disease
Volume18
Issue number1
StatePublished - Jan 2009

Fingerprint

Aortic Valve
Reoperation
Survival
Aortic Valve Insufficiency
Tricuspid Valve
Replantation
Bicuspid
Marfan Syndrome
Bicuspid Aortic Valve
Mitral Valve
Coronary Artery Disease

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Sareyyupoglu, B., Suri, R. M., Schaff, H. V., Dearani, J. A., Daly, R. C., Orszulak, T. A., & Sundt, T. M. (2009). Survival and reoperation risk following bicuspid aortic valve-sparing root replacement. Journal of Heart Valve Disease, 18(1), 1-8.

Survival and reoperation risk following bicuspid aortic valve-sparing root replacement. / Sareyyupoglu, Basar; Suri, Rakesh M.; Schaff, Hartzell V; Dearani, Joseph A.; Daly, Richard C.; Orszulak, Thomas A.; Sundt, Thoralf M.

In: Journal of Heart Valve Disease, Vol. 18, No. 1, 01.2009, p. 1-8.

Research output: Contribution to journalArticle

Sareyyupoglu, B, Suri, RM, Schaff, HV, Dearani, JA, Daly, RC, Orszulak, TA & Sundt, TM 2009, 'Survival and reoperation risk following bicuspid aortic valve-sparing root replacement', Journal of Heart Valve Disease, vol. 18, no. 1, pp. 1-8.
Sareyyupoglu B, Suri RM, Schaff HV, Dearani JA, Daly RC, Orszulak TA et al. Survival and reoperation risk following bicuspid aortic valve-sparing root replacement. Journal of Heart Valve Disease. 2009 Jan;18(1):1-8.
Sareyyupoglu, Basar ; Suri, Rakesh M. ; Schaff, Hartzell V ; Dearani, Joseph A. ; Daly, Richard C. ; Orszulak, Thomas A. ; Sundt, Thoralf M. / Survival and reoperation risk following bicuspid aortic valve-sparing root replacement. In: Journal of Heart Valve Disease. 2009 ; Vol. 18, No. 1. pp. 1-8.
@article{e7a3fca4fa464a1ea2ea450c38491649,
title = "Survival and reoperation risk following bicuspid aortic valve-sparing root replacement",
abstract = "Background and aim of the study: The mid-term out-come of aortic valve-sparing root replacement, reim-planting native bicuspid versus tricuspid aortic valves, is unclear. Methods: The records of 84 consecutive patients (66 men, 18 women; mean age 46.6 years) who had undergone aortic valve-sparing root replacement using the reimplantation technique between January 1997 and July 2006, were reviewed. Among the patients, 26 (31{\%}) had Marfan syndrome and 14 (17{\%}) had a bicuspid aortic valve. The mean follow up period was 4.1 years. Results: There were three early deaths (4{\%}) and five late deaths (6{\%}). Late survival (>30 days) at five and eight years was 95{\%} and 88{\%}, respectively. The pres-ence of significant coronary artery disease (p = 0.001), a lower preoperative ejection fraction (p = 0.03) and older age (p = 0.04) were the only univariate predic-tors of death. Freedom from moderate-severe or severe (grade 3 or 4) aortic valve regurgitation at one and five years was 91{\%} and 77{\%}, respectively. Ten patients (12{\%}) required aortic valve reoperation at a mean of 3.4 years after surgery (3/14 bicuspid, 7/70 tricuspid); however, only one reoperation was required among patients undergoing the initial sur-gery after the year 2000. Freedom from aortic valve reoperation at one and five years was 95{\%} and 83{\%}, respectively. The predischarge degree of aortic valve regurgitation was the sole univariate factor associat-ed with aortic valve reoperation (p = 0.008). Bicuspid valve morphology was not a predictor of either recur-rent aortic valve regurgitation, nor of aortic valve reoperation. Conclusion: Bicuspid aortic valves may be safely spared by reimplantation during replacement of the aortic root, with similar mid-term durability as for tricuspid aortic valves.",
author = "Basar Sareyyupoglu and Suri, {Rakesh M.} and Schaff, {Hartzell V} and Dearani, {Joseph A.} and Daly, {Richard C.} and Orszulak, {Thomas A.} and Sundt, {Thoralf M.}",
year = "2009",
month = "1",
language = "English (US)",
volume = "18",
pages = "1--8",
journal = "Journal of Heart Valve Disease",
issn = "0966-8519",
publisher = "ICR Publishers Ltd",
number = "1",

}

TY - JOUR

T1 - Survival and reoperation risk following bicuspid aortic valve-sparing root replacement

AU - Sareyyupoglu, Basar

AU - Suri, Rakesh M.

AU - Schaff, Hartzell V

AU - Dearani, Joseph A.

AU - Daly, Richard C.

AU - Orszulak, Thomas A.

AU - Sundt, Thoralf M.

PY - 2009/1

Y1 - 2009/1

N2 - Background and aim of the study: The mid-term out-come of aortic valve-sparing root replacement, reim-planting native bicuspid versus tricuspid aortic valves, is unclear. Methods: The records of 84 consecutive patients (66 men, 18 women; mean age 46.6 years) who had undergone aortic valve-sparing root replacement using the reimplantation technique between January 1997 and July 2006, were reviewed. Among the patients, 26 (31%) had Marfan syndrome and 14 (17%) had a bicuspid aortic valve. The mean follow up period was 4.1 years. Results: There were three early deaths (4%) and five late deaths (6%). Late survival (>30 days) at five and eight years was 95% and 88%, respectively. The pres-ence of significant coronary artery disease (p = 0.001), a lower preoperative ejection fraction (p = 0.03) and older age (p = 0.04) were the only univariate predic-tors of death. Freedom from moderate-severe or severe (grade 3 or 4) aortic valve regurgitation at one and five years was 91% and 77%, respectively. Ten patients (12%) required aortic valve reoperation at a mean of 3.4 years after surgery (3/14 bicuspid, 7/70 tricuspid); however, only one reoperation was required among patients undergoing the initial sur-gery after the year 2000. Freedom from aortic valve reoperation at one and five years was 95% and 83%, respectively. The predischarge degree of aortic valve regurgitation was the sole univariate factor associat-ed with aortic valve reoperation (p = 0.008). Bicuspid valve morphology was not a predictor of either recur-rent aortic valve regurgitation, nor of aortic valve reoperation. Conclusion: Bicuspid aortic valves may be safely spared by reimplantation during replacement of the aortic root, with similar mid-term durability as for tricuspid aortic valves.

AB - Background and aim of the study: The mid-term out-come of aortic valve-sparing root replacement, reim-planting native bicuspid versus tricuspid aortic valves, is unclear. Methods: The records of 84 consecutive patients (66 men, 18 women; mean age 46.6 years) who had undergone aortic valve-sparing root replacement using the reimplantation technique between January 1997 and July 2006, were reviewed. Among the patients, 26 (31%) had Marfan syndrome and 14 (17%) had a bicuspid aortic valve. The mean follow up period was 4.1 years. Results: There were three early deaths (4%) and five late deaths (6%). Late survival (>30 days) at five and eight years was 95% and 88%, respectively. The pres-ence of significant coronary artery disease (p = 0.001), a lower preoperative ejection fraction (p = 0.03) and older age (p = 0.04) were the only univariate predic-tors of death. Freedom from moderate-severe or severe (grade 3 or 4) aortic valve regurgitation at one and five years was 91% and 77%, respectively. Ten patients (12%) required aortic valve reoperation at a mean of 3.4 years after surgery (3/14 bicuspid, 7/70 tricuspid); however, only one reoperation was required among patients undergoing the initial sur-gery after the year 2000. Freedom from aortic valve reoperation at one and five years was 95% and 83%, respectively. The predischarge degree of aortic valve regurgitation was the sole univariate factor associat-ed with aortic valve reoperation (p = 0.008). Bicuspid valve morphology was not a predictor of either recur-rent aortic valve regurgitation, nor of aortic valve reoperation. Conclusion: Bicuspid aortic valves may be safely spared by reimplantation during replacement of the aortic root, with similar mid-term durability as for tricuspid aortic valves.

UR - http://www.scopus.com/inward/record.url?scp=65349152531&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=65349152531&partnerID=8YFLogxK

M3 - Article

C2 - 19301547

AN - SCOPUS:65349152531

VL - 18

SP - 1

EP - 8

JO - Journal of Heart Valve Disease

JF - Journal of Heart Valve Disease

SN - 0966-8519

IS - 1

ER -