Bicuspid aortic valve repair: systematic review on long-term outcomes.

Autor:	Arnaoutakis GJ; Division of Thoracic and Cardiovascular Surgery, University of Florida, Gainesville, Florida, USA., Sultan I; Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA., Siki M; Division of Cardiovascular Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA., Bavaria JE; Division of Cardiovascular Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Jazyk:	angličtina
Zdroj:	Annals of cardiothoracic surgery [Ann Cardiothorac Surg] 2019 May; Vol. 8 (3), pp. 302-312.
DOI:	10.21037/acs.2019.05.08
Abstrakt:	Background: Many patients with bicuspid aortic valve (BAV) develop aortic regurgitation but are not considered for valve repair. This is partly due to limited long term data regarding repair durability. The purpose of the review is to summarize the long-term (1 year) outcomes of BAV repair. Methods: A systematic review was performed to evaluate durability and survival following BAV repair. OVID SP versions of MEDLINE and Embase were searched using 'aortic valve', 'bicuspid', 'repair', 'David' 'Yacoub', 'reimplantation' and 'remodeling'. Results: Initial search produced 770 abstracts, reduced to 92 full papers for review after excluding duplications and abstract review for relevance. Twenty-six studies met full inclusion criteria. BAV repair revealed low operative mortality, with excellent 5-year survival, and low freedom from reoperation. Differences in surgical technique between reimplantation and remodeling do not appear to confer protection against reintervention. Systematic assessment of cusp height and annular stabilization in some form do appear to favor improved long term durability. Leaflet calcification is associated with higher rates of reintervention. Conclusions: BAV repair is associated with acceptable long term survival. Ongoing standardized outcome assessments will further refine surgical techniques associated with excellent repair durability. Competing Interests: Conflicts of Interest: GJ Arnaoutakis—Consultant for Bolton Medical, Inc.; JE Bavaria—Research Grant, Edwards Lifesciences Corporation, Medtronic, Inc., COOK Medical, Boston Scientific, W.L. Gore & Associates, St Jude Medical. The other authors have no conflicts of interest to declare.
Databáze:	MEDLINE
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