Bicuspid aortic valve repair: outcomes after 17 years of experience
| Autor: | Radosław Gocoł, Roman Przybylski, Marek A. Deja, Marceli Lukaszewski, Marta Obremska, Rafał Nowicki, Grzegorz Bielicki, Jakub Jasinski, Marek Jasinski, Andrzej Kansy, Anna Larysz, Kinga Kosiorowska, Mikolaj Berezowski |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine medicine.medical_specialty Bicuspid aortic valve Aortic Valve Insufficiency 030204 cardiovascular system & hematology Preoperative care Cardiac Valve Annuloplasty 03 medical and health sciences 0302 clinical medicine Aortic valve repair Bicuspid Aortic Valve Disease Medicine Conventional Aortic Surgery Humans Risk factor Cardiac Surgical Procedures Repair failure risk factors Eacts/115 Retrospective Studies business.industry AcademicSubjects/MED00920 Sinotubular Junction Hazard ratio General Medicine Middle Aged medicine.disease Confidence interval Surgery Treatment Outcome medicine.anatomical_structure 030228 respiratory system Ventricle Aortic Valve Cardiology and Cardiovascular Medicine business Eacts/125 |
| Zdroj: | European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery |
| ISSN: | 1873-734X 1010-7940 |
| Popis: | OBJECTIVES This study presents the results of 17 years of experience with bicuspid aortic valve (BAV) repair and the analysis of factors associated with repair failure and early echocardiographic outcome. METHODS Between 2003 and 2020, a total of 206 patients [mean age: 44.5 ± 15.2 years; 152 males (74%)] with BAV insufficiency with or without aortic dilatation underwent elective aortic valve repair performed by a single surgeon with a mean follow-up of 5 ± 3.5 years. The transthoracic echocardiography examinations were reported. RESULTS There were no deaths during the hospital stay, and all but 1 patient survived the follow-up period (99.5%). Overall, 10 patients (5%) developed severe insufficiency and 2 (1%) developed aortic dilatation requiring reoperation. Freedom from reoperation at 7 years reached 91.8%. Type 2 BAV configuration [hazard ratio (HR) 3.9; 95% confidence interval (CI): 1.01–60; P = 0.049], no sinotubular junction remodelling (HR 7; 95% CI: 1.7–23; P = 0.005), no circumferential annuloplasty (HR 3.9; 95% CI: 1.01–64; P = 0.047) and leaflet resection (HR 5.7; 95% CI 1.2–13. P = 0.017) have been identified as a risk factor of redo operation. Parameters of the postoperative left ventricle reverse remodelling improved significantly early after the operation and later at 2 years evaluation. CONCLUSIONS The repair of BAV offers good short- and mid-term results providing a significant reverse left ventricular remodelling. Type 0 BAV preoperative configuration, circumferential annuloplasty and sinotubular junction remodelling are associated with better repair durability. |
| Databáze: | OpenAIRE |
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