The Surgical Management Of Bicuspid Aortic Valve With The Dilated Ascending Aorta

OBJECTIVES Bicuspid aortic valve(BAV)is the most common congenital valvular abnormality and frequently presents with accelerated calcific aortic valve disease,requiring aortic valve replacement(AVR)and thoracic aortic aneurysm and dissection.Supporting evidence for Association Guidelines of aortic dimensions for aortic resection is sparse.We sought to determine whether concurrent repair of dilated or aneurysmal aortic disease during AVR in patients with BAV substantially improves morbidity and mortality outcomes.METHODS Collect and choose between January 2010 and December 2010,for the first time,the first hospital of Lanzhou University during aortic surgery treatment of adult patients with aortic valve disc 2,deformity 36 cases,30 cases of men,women and 6 cases in accordance with the operation method of divided into pure lines of aortic valve replacement(AVR)group and aortic valve replacement and repair the ascending aorta(AVR-AR)group.After observation and follow-up,the patients were collected and compared the preoperative and postoperative cardiac color ultrasound examination,the general condition of the patient and the postoperative follow-up rate or mortality.RESULTS Clinically important differences in patient characteristics,aortic valve function and aortic dimensions were identified between cohorts.Event rates were low,with rates of reoperation and death within 1 year of only 1.8% and 5.4%,respectively,and no aortic dissection observed during follow-up.There were no significant differences in reoperation or mortality outcomes between the AVR-only and AVR-AR cohorts.Age,aortic dimension or a combination thereof was not associated with better or worse outcomes after each AVR-AR compared with AVR.CONCLUSIONS We conclude AVR-only and AVR-AR surgery have low morbidity and mortality and have utility over a wide range of age and aortic sizes.Our results do not provide support for the 45-mm aortic dimension recommended in the current guidelines for aortic resection while performing AVR or any other specific dimension.