Therapeutic results of three-dimensional aortic valve anatomic repair for regurgitant bicuspid aortic valve
10.3760/cma.j.cn112139-20240212-00071
- VernacularTitle:二叶主动脉瓣反流病变三维解剖修复的治疗效果
- Author:
Jun LI
1
;
Chunsheng WANG
;
Zheng ZUO
;
Hao LAI
;
Lili DONG
;
Kai ZHU
;
Junyu ZHAI
;
Yongxin SUN
;
Wenjun DING
;
Tao HONG
Author Information
1. 复旦大学附属中山医院心外科 上海市心血管病研究所，上海 200032
- Keywords:
Aortic valve insufficiency;
Cardiac surgical procedures;
Aortic valve repair;
Bicuspid aortic valve disease;
Aortic root
- From:
Chinese Journal of Surgery
2024;62(11):1024-1031
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the surgical technique and results of three-dimensional aortic valve anatomic repair for bicuspid aortic valve (BAV) with aortic regurgitation (AR).Methods:This is a retrospective case series study. From August 2021 to December 2023, 130 consecutive patients with BAV-AR underwent aortic valve anatomic repair at the Department of Cardiothoracic Surgery, Zhongshan Hospital, Fudan University,and the data were retrospectively analyzed. There were 115 males and 15 females, aged (38.6±11.7) years (range: 15 to 67 years). All patients received modified aortic root reconstruction, to do three-dimensional root remodeling, including the basal ring, sinus of Valsalva and sino-tubular junction simultaneously. Perioperative and follow-up data were collected and analyzed. Comparisons between groups were performed using independent samples t-test, Wilcoxon paired signed-rank test, or χ2 test. Results:No patient transferred to valve replacement during the operation. The cardiopulmonary bypass time ( M(IQR)) was 109(34) minutes (range:67 to 247 minutes), and the aortic cross-clamp time was 76(26) minutes (range: 32 to 158 minutes). Preoperative transesophageal echocardiography showed 123 patients (94.6%) presented with moderate or severe regurgitation. Immediately postoperative transesophageal echocardiography showed no regurgitation in 22 patients (16.9%), trace regurgitation in 81 patients (62.3%) and mild regurgitation in 27 patients (20.8%). Follow up was completed in all patients, with a follow-up of 5.5(9.4) months (range: 0.1 to 27.6 months). No mortality was observed during follow-up. Echocardiography was obtained in 112 patients at the latest follow-up, including no regurgitation in 4 patients (3.6%), trace regurgitation in 58 patients (51.8%), mild regurgitation in 45 patients (40.2%), moderate regurgitation in 4 patients (3.6%), and severe regurgitation in 1 patient (0.9%). Conclusion:For patients with BAV-AR who have good valve quality and no severe aortic sinus dilation, the recent outcomes of three-dimensional anatomical repair technique, focusing on overall remodeling of the aortic root, are satisfactory.
