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

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19 Scopus citations

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

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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.