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THE JOURNAL OF CARDIOVASCULAR SURGERY

Rivista di Chirurgia Cardiaca, Vascolare e Toracica


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The Journal of Cardiovascular Surgery 2003 February;44(1):19-23

Copyright © 2009 EDIZIONI MINERVA MEDICA

lingua: Inglese

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


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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.

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