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The Journal of Cardiovascular Surgery 2020 April;61(2):250-5

DOI: 10.23736/S0021-9509.20.11051-6


lingua: Inglese

Sleeve valve-sparing procedure in bicuspid aortic valve: early and midterm clinical results

Giordano TASCA 1, 2 , Francesco TRINCA 1, Beatrice RIVA 3, Elisabetta LOBIATI 3, Andrea NASATTI 4, Paolo FACCIOLI 4, Amando GAMBA 1

1 Operative Unit of Cardiac Surgery, Cardiovascular Department, ASST-Lecco, A. Manzoni Hospital, Lecco, Italy; 2 Cardiac Surgery Unit, Heart Health Center, King Saud Medical City, Kingdom of Saudi Arabia; 3 Operative Unit of Cardiology, ASST-Lecco, A. Manzoni Hospital, Lecco, Italy; 4 Department of Radiology, ASST-Lecco, A. Manzoni Hospital, Lecco, Italy

BACKGROUND: Patients with aortic root ectasia and bicuspid aortic valve benefit of the treatment with aortic valve sparing procedure, with excellent long-term results. The Sleeve-procedure is one of the options in patients with aortic root diseases and it might be suitable for patients with a bicuspid valve.
METHODS: From October 2006 to December 2018, 42 consecutive patients with bicuspid aortic valve and aortic root ectasia/aneurysm, with or without aortic regurgitation, were surgically treated with the Sleeve-procedure.
RESULTS: In 20 patients (48%) leaflets surgery was necessary and consisted of raphe mobilization/resection in 17 patients, plication of both leaflets in 2 patients and a two-commissures resuspension in 1 patient. During a mean clinical follow-up time of 4.4±3.1 years, the survival rate was 100%, 1 patient required a reoperation at 6.1 years postoperatively, with an overall freedom from reoperation of 94±5%. The rest of the patients (41/42), had no more than mild residual aortic valve regurgitation. With a mean follow-up of 4.3±1.7 years the magnetic resonance imaging performed in 26 patients, did not show signs of aortic wall herniation through the key-holes or persisting creases of the aortic wall inside the prosthesis.
CONCLUSIONS: Patients with aortic root disease and bicuspid aortic valve may be treated with Sleeve technique with excellent midterm results. However, a longer follow-up is required before drawing any solid conclusion.

KEY WORDS: Adult; Bicuspid aortic valve; Surgical procedure, operative

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