Background and aims of the study. Data on emergency surgery for
acute type A aortic dissection in patients with bicuspid aortic valve
were limited. Long-term results on the fate of the preserved bicuspid
valve and aortic root were even rare. We sought to assess the clinical
outcome of emergency acute type A aortic dissection surgery in patients
with bicuspid aortic valve. Methods. From 2004 to 2021, 121
patients underwent emergency surgery for acute type A aortic dissection
using a conservative aortic resection. Hospital and late outcomes were
assessed in patients with bicuspid aortic valve. Results. Eight
patients (6.6%) had bicuspid aortic valve with 6 males (75%) and
median age of 49.5 years (range, 34 to 71). Four (50%) had significant
aortic valve dysfunction. Operation included ascending aortic grafting
with aortic valve preservation in 4, ascending aortic grafting with
aortic valve replacement in 3 and ascending aortic grafting with Bentall
root replacement in 1. Hospital mortality rate was 12.5% (1/8). With a
median follow-up of 14.4 years, there was one late death and no proximal
reoperation of 6 preserved roots and 3 preserved valves. Median diameter
of preserved aortic roots changed from 42 (range, 33-43) to 38.5 mm
(range, 35-46) with the average time of 11 years after surgery.
Conclusions. Acute type A aortic dissection in bicuspid aortic
valve was not associated with worse outcome. Aortic valve replacement
was often required. Simultaneous root replacement was not always
necessary. Preservation of normally functioning bicuspid valve and
non-dilated root showed durable long-term results.
A Case of an Elderly Patient Suffering from Acute Type A Aortic Dissection Who Received Conservative Treatment 3 Years after Aortic Valve Replacement
