Long-term follow-up of supra-annular pulmonary autograft aortic root replacement in patients with bicuspid aortic valve☆

Aim: Emphasis in this study was placed on clinical and functional assessment of a modified "Florida Sleeve" procedure during surgical correction of ascending aorta aneurysms with concomitant aortic insufficiency. Methods: 32 patients with an aneurysm of the ascending aorta and aortic insufficiency underwent a modified "Florida Sleeve" procedure. The average follow-up was 17 (0-60) months. The average age of patients was 57±13 (23-73) years 56±13 years. Results: The expected 4-year cumulative survival rate was 84.3%. Overall freedom from aortic insufficiency in the late period was 88.9%. Median aortic regurgitation was 1+ (1; 2). Long-term follow-up revealed no valve-associated complications. Conclusion: The aortic root reimplantation procedure enables optimal correction of the existing lesions of the aortic root without performing aortic valve replacement and demonstrates stable clinical and functional outcomes in the long-term period.Key words: aortic aneurysm; aortic valve; valve-sparing operations.FundingThe study had no sponsorship.Conflict of interestThe authors declare no conflict of interest.

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Longer-term Outcomes after Bicuspid Aortic Valve Repair in 142 Patients

10.22541/au.162462292.29315155/v1 ◽

2021 ◽

Author(s):

Mojyan Safari ◽

Nadejda Monsefi ◽

Afsaneh Karimian-Tabrizi ◽

Aleksandra Miskovic ◽

A Vanlinden ◽

...

Keyword(s):

Aortic Valve ◽

Bicuspid Aortic Valve ◽

Aortic Root ◽

Reoperation Rate ◽

Aortic Root Replacement ◽

Aortic Root Dilatation ◽

Group 2 ◽

Aortic Valve Reimplantation ◽

Group 1

Background The aim of this study was to evaluate the longer-term results of bicuspid aortic valve (BAV) repair with or without aortic root replacement. Methods From 1999 to 2017, 142 patients with or without aortic root dilatation who underwent repair of a regurgitant BAV were included in the study. Ninety-four patients underwent isolated BAV repair (Group 1; mean age 45±14 years) and 48 patients underwent valve-sparing aortic root replacement plus BAV repair (aortic valve reimplantation – Group 2; mean age 49±13 years. Median follow-up time was 5.9 years (range 0.5-15) in Group 1 and 3 years (range 0.5-16) in Group 2, respectively. Results In-hospital mortality was 1% in group 1, and 2% in Group 2 (p=0.6). The 5- and 10-year survival was 93±2.9% and 81±5.8% in Group 1 and 96±3.1% and 96±3.1% in Group 2, respectively (p=0.31). Eleven patients of Group 1 (1.7% /patient-year) and 5 patients of Group 2 (2.2%/patient-year) underwent reoperation of the aortic valve (p=0.5). The 5- and 10-year freedom from reoperation were 93.0±2.1% and 77.1±7.1% in Group 1 and 93.0±5.0% and 76.7±9.6% in Group 2 (p=0.83), respectively. At latest follow-up only 2 patients of Group 1 and 1 patient of Group 2 had AR=2° (p=0.7). The cumulative linearized incidence of all valve-related complications (bleeding, stroke, endocarditis, reoperation) was 2.9%/patient-year in Group 1 and 4%/patient-year in Group 2, respectively (p=0.6). Conclusions Isolated BAV repair and combined aortic valve reimplantation plus BAV repair provide good clinical longer-term outcomes with relatively low reoperation rate and durable valve function.

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Long-term follow-up after aortic root replacement with the Shelhigh® biological valved conduit: a word of caution!

European Journal of Cardio-Thoracic Surgery ◽

10.1093/ejcts/ezw167 ◽

2016 ◽

Vol 50 (6) ◽

pp. 1172-1178 ◽

Cited By ~ 8

Author(s):

Ayhan Sahin ◽

Oliver Müggler ◽

Juri Sromicki ◽

Etem Caliskan ◽

Diana Reser ◽

...

Keyword(s):

Aortic Root ◽

Aortic Root Replacement ◽

Long Term Follow Up ◽

Valved Conduit

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Faculty Opinions recommendation of Dilatation of the remaining aorta after aortic valve or aortic root replacement in patients with bicuspid aortic valve: a 5-year follow-up.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718013037.793480970 ◽

2013 ◽

Author(s):

Juan-Carlos Kaski ◽

Amelia Carro

Keyword(s):

Aortic Valve ◽

Bicuspid Aortic Valve ◽

Aortic Root ◽

Aortic Root Replacement

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Long-Term Survival After Composite Mechanical Aortic Root Replacement

Aorta ◽

10.12945/j.aorta.2016.15.039 ◽

2016 ◽

Vol 04 (04) ◽

pp. 146-147

Author(s):

Khaled Al-Ebrahim ◽

Husain Jabbad ◽

Ahmad Alqari

Keyword(s):

Aortic Root ◽

Mechanical Valve ◽

Composite Graft ◽

Aortic Root Replacement ◽

Term Survival ◽

Long Term Survival ◽

Long Term Follow Up

AbstractThis report describes the long-term follow-up of the repair of a giant ascending aneurysm using a composite graft with a mechanical valve.

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Early and long-term results of aortic valve sparing aortic root reimplantation surgery for bicuspid and tricuspid aortic valves

Perfusion ◽

10.1177/0267659119831926 ◽

2019 ◽

Vol 34 (6) ◽

pp. 482-489 ◽

Cited By ~ 1

Author(s):

Dainius Karciauskas ◽

Vaida Mizariene ◽

Povilas Jakuska ◽

Egle Ereminiene ◽

Paulius Orda ◽

...

Keyword(s):

Aortic Valve ◽

Bicuspid Aortic Valve ◽

Aortic Root ◽

Valve Regurgitation ◽

Aortic Valves ◽

Tricuspid Aortic Valve ◽

Patient Groups ◽

Valve Sparing

Introduction: To evaluate early and long-term clinical outcomes following aortic valve sparing aortic root reimplantation surgery in patients with leaking bicuspid and tricuspid aortic valves. Methods: The study consisted of 92 consecutive adult patients (tricuspid aortic valve group = 63 and bicuspid aortic valve group = 29) who underwent aortic valve sparing aortic root reimplantation surgery with or without aortic cusp repair for dilatation of the aortic root and/or aortic valve regurgitation at our institution from April 2004 to October 2016. Clinical outcomes were investigated using Kaplan–Meier and log-rank tests between groups. Results: The follow-up was 100% complete with a mean time of 5.3 ± 3.3 years. The 30-day in-hospital mortality was 3.1% in tricuspid aortic valve group and 3.4% in bicuspid aortic valve group patients. The overall survival rates at 10 years did not differ between bicuspid aortic valve and tricuspid aortic valve patient groups (96.6 ± 3.3% vs. 90.3 ± 4.2%, p = 0.3). Freedom from recurrent aortic valve regurgitation (>2+) at 10 years was 90.5 ± 4.1% in tricuspid aortic valve group and 75.7 ± 8.7% in bicuspid aortic valve group (p = 0.06). Freedom from aortic valve reoperation at 10 years was 100% in tricuspid aortic valve group and 83.9 ± 7.4% in bicuspid aortic valve group (p = 0.002). Conclusion: Aortic valve sparing aortic root reimplantation surgery is a safe and efficient technique, providing acceptable long-term survival with low rates of valve-related complications in both tricuspid aortic valve and bicuspid aortic valve patient groups. However, aortic valve reoperation rates at 10 years follow-up were higher in bicuspid aortic valve group patients compared to tricuspid aortic valve group patients.

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