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THE JOURNAL OF CARDIOVASCULAR SURGERY
Rivista di Chirurgia Cardiaca, Vascolare e Toracica
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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ORIGINAL ARTICLES CARDIAC SECTION
The Journal of Cardiovascular Surgery 2003 February;44(1):19-23
Midterm results of conservative repair of the incompetent bicuspid aortic valve
Kin H., Izumoto H., Nakajima T., Kawase T., Kamata J., Ishihara K., Kawazoe K.
Department of Cardiovascular Surgery Iwate Medical University Memorial Heart Center, Iwate, Japan
Aim. Repair of the bicuspid aortic valve is not generally considered the treatment of choice. Our success with this procedure leads us to report our immediate and mid-term results.
Methods. From August 1993 to December 2000, 19 patients with aortic regurgitation due to congenital aortic valve underwent aortic valve repair (17 men and 2 women with a mean age of 42±17 years; range, 16 to 70 years). The mean preoperative aortic regurgitation grade was 3.1±0.8 on a scale of 1 to 4. Mean preoperative New York Heart Association functional class was 1.9±0.8. Fourteen patients had pure aortic regurgitation, 2 also had infectious endocarditis, 1 had angina pectoris, and 2 had an ascending aortic aneurysm.
Results. There was 1 hospital death (5.2%), and 1 patient required re-operation due to recurrent infectious endocarditis. Mean aortic regurgitation grade at discharge was 1.1±0.9, and functional class was 1.1±0.2. All patients were followed for a mean duration of 40±23 months (range, 0.5 to 84 months). There was 1 late death, and two patients required aortic valve replacement. The 5-year survival rate was 90±7%. The 1- and 5-year re-operation-free rates were 87±12% and 76±23%.
Conclusion. Bicuspid aortic valve repair is a safe procedure with good early postoperative results. However midterm results are not satisfactory. Re-operation is a promising alternative and progress aortic regurgitation were complications. Bicuspid aortic valve repair to valve replacement that requires additional study to individualize treatment.