Aortic valve repair for quadricuspid aortic valve associated with aortic regurgitation and ascending aortic aneurysm

Quadricuspid aortic valve is a rare anomaly, and most patients require surgery for aortic regurgitation in the 5th or 6th decades of life; only a few cases of aortic valve repair in childhood have been reported. A 3-year-old boy was scheduled for ventricular septal defect closure and aortic valve repair. Quadricuspid aortic valve was an incidental finding at operation; it was repaired by joining the left anterior and right anterior cusps. At the 9-month follow-up, the patient had no more than mild aortic regurgitation. We emphasize the importance of detecting this anomaly, especially in children with aortic valve regurgitation.

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Early and Late-Term Follow-Up Results of Patients Diagnosed with Aortic Aneurysm or Aortic Dissection with Aortic Regurgitation Undergoing Aortic Valve Repair or Valve-Sparing Aortic Surgery

Brazilian Journal of Cardiovascular Surgery ◽

10.21470/1678-9741-2020-0133 ◽

2020 ◽

Author(s):

Görkem Yiği ◽

Anıl Özen ◽

Ferit Çetinkaya ◽

Ertekin Utku Üna ◽

Hakki Zafer İşcan ◽

...

Keyword(s):

Aortic Valve ◽

Aortic Aneurysm ◽

Aortic Dissection ◽

Aortic Regurgitation ◽

Aortic Surgery ◽

Aortic Valve Repair ◽

Valve Repair ◽

Valve Sparing

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Quadricuspid Aortic Valve Repair Facilitated by Geometric Ring Annuloplasty

Innovations Technology and Techniques in Cardiothoracic and Vascular Surgery ◽

10.1177/15569845211003095 ◽

2021 ◽

pp. 155698452110030

Author(s):

Joseph A. McGuire ◽

Heather K. Hayanga ◽

Jeremiah W. Hayanga ◽

Daniel Sloyer ◽

Matthew Ellison ◽

...

Keyword(s):

Aortic Valve ◽

Patient Outcomes ◽

Systematic Approach ◽

Aortic Insufficiency ◽

Aortic Valve Repair ◽

Autologous Reconstruction ◽

Quadricuspid Aortic Valve ◽

Valve Repair ◽

Ring Annuloplasty ◽

Annular Geometry

Quadricuspid aortic valve (QAV) is a rare congenital anomaly often associated with aortic insufficiency. The exact anatomy of QAV is variable, and most cases have undergone aortic valve replacement. With the recognition that aortic valve repair achieves superior patient outcomes as compared to replacement, a systematic approach to autologous reconstruction of QAV is needed. This article reports 2 cases having successful repair utilizing geometric aortic annuloplasty rings, and describes a proposed scheme for repairing most QAV defects, based on relative leaflet and commissural characteristics. Using either tri-leaflet or bicuspid ring annuloplasty, the normal sub-commissural triangles can be remodeled into a 120° or 180° configuration, respectively, and then the leaflets can be sutured and plicated to fit annular geometry. With this approach, most quadricuspid valves potentially could undergo autologous reconstruction.

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Echocardiographic predictors of aortic valve repair in patients with bicuspid valves and aortic regurgitation

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(03)82785-7 ◽

2003 ◽

Vol 41 (6) ◽

pp. 516 ◽

Cited By ~ 1

Author(s):

Patrick J. Nash ◽

Eugene Vitvitsky ◽

Delos M. Cosgrove ◽

Gosta Pettersson ◽

Richard A. Grimm

Keyword(s):

Aortic Valve ◽

Aortic Regurgitation ◽

Aortic Valve Repair ◽

Valve Repair

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Valve Repair in Aortic Regurgitation without Root Dilatation - Aortic Valve Repair

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-2005-872961 ◽

2006 ◽

Vol 54 (1) ◽

pp. 15-20 ◽

Cited By ~ 11

Author(s):

H. F. Lausberg ◽

D. Aicher ◽

A. Kissinger ◽

F. Langer ◽

R. Fries ◽

...

Keyword(s):

Aortic Valve ◽

Aortic Regurgitation ◽

Aortic Valve Repair ◽

Valve Repair

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Quadricuspid aortic valve repair

ASVIDE ◽

10.21037/asvide.2019.169 ◽

2019 ◽

Vol 6 ◽

pp. 169-169

Author(s):

Stefano Mastrobuoni ◽

Gaby Aphram ◽

Saadallah Tamer ◽

Emiliano Navarra ◽

Laurent De Kerchove ◽

...

Keyword(s):

Aortic Valve ◽

Aortic Valve Repair ◽

Quadricuspid Aortic Valve ◽

Valve Repair

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Mid-term durability of polytetrafluoroethylene patches in unicuspid aortic valve repair

Interactive CardioVascular and Thoracic Surgery ◽

10.1093/icvts/ivaa136 ◽

2020 ◽

Vol 31 (4) ◽

pp. 555-558

Author(s):

Irem Karliova ◽

Tristan Ehrlich ◽

Shunsuke Matsushima ◽

Sebastian Ewen ◽

Hans-Joachim Schäfers

Keyword(s):

Aortic Valve ◽

Aortic Regurgitation ◽

Valve Replacement ◽

Aortic Valve Repair ◽

Valve Repair ◽

Severe Aortic Regurgitation ◽

Aortic Replacement ◽

Primary Indication ◽

Ascending Aortic Replacement

Abstract OBJECTIVES Unicuspid aortic valve (UAV) morphology is a cause for aortic valve dysfunction in childhood or adolescence. Repair requires the use of patch material, and polytetrafluoroethylene (PTFE) has been proposed for this purpose because of lack of calcification. We reviewed our mid-term experience with PTFE for the repair of UAV to analyse the durability of this technique. METHODS Out of 21 patients with an UAV undergoing aortic valve repair for severe aortic regurgitation between 2014 and 2016, 11 patients (52%) were treated using PTFE patch material. Aortic regurgitation was present in all patients, the primary indication for surgery was regurgitation in 8, stenosis in 2 and aneurysm in 1. Symmetric bicuspidization of the UAV was performed in all. One patient required additional root remodelling for root dilatation, and another 3 tubular ascending aortic replacement. RESULTS No patient died in hospital or during follow-up. Seven patients (63.6%) required reoperation for progressive AR. Freedom from reoperation was 58% at 1 and 35% at 5 years postoperatively. At reoperation the PTFE patches were found dehisced from aortic wall and/or native cusp tissue. In 3 patients re-repair was performed; a stable result was achieved in 1. Two patients underwent valve replacement 3 months and 1 year postoperatively. The other 4 patients underwent valve replacement. CONCLUSIONS The repair of UAVs using PTFE patch is associated with poor durability, a more durable patch with better healing characteristics material is needed.

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