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AVNeo improves early haemodynamics in regurgitant bicuspid aortic valves compared to aortic valve repair

Interactive cardiovascular and thoracic surgery, 2022-10, Vol.35 (5) [Peer Reviewed Journal]

The Author(s) 2022. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. 2022 ;ISSN: 1569-9285 ;ISSN: 1569-9293 ;EISSN: 1569-9285 ;DOI: 10.1093/icvts/ivac226 ;PMID: 36018270

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  • Title:
    AVNeo improves early haemodynamics in regurgitant bicuspid aortic valves compared to aortic valve repair
  • Author: Prinzing, Anatol ; Böhm, Johannes ; Sideris, Konstantinos ; Vitanova, Keti ; Lange, Rüdiger ; Krane, Markus
  • Subjects: Adult Cardiac
  • Is Part Of: Interactive cardiovascular and thoracic surgery, 2022-10, Vol.35 (5)
  • Description: Abstract OBJECTIVES Calcified or fibrotic cusps in patients with bicuspid aortic valves and aortic regurgitation complicate successful aortic valve (AV)-repair. Aortic valve neocuspidization (AVNeo) with autologous pericardium offers an alternative treatment to prosthetic valve replacement. We compared patients with regurgitant bicuspid valves undergoing AV-repair or AVNeo. METHODS We retrospectively analysed patients with regurgitant bicuspid valves undergoing AV-repair or AVNeo. We focused on residual regurgitation, pressure gradients and effective orifice area, determined preoperatively and at discharge. RESULTS AV-repair was performed in 61 patients (mean age: 43.2 ± 11.3 years) and AVNeo in 22 (45.7 ± 14.1). Prior to the operation patients of the AV-repair group showed severe regurgitation in 38 cases (62.3%) and moderate in 23 (37.6%); in the AVNeo group, all patients exhibited severe regurgitation. Postoperatively, 57 patients (93.4%) patients had no or mild regurgitation after AV-repair and 21 (95.4%) after AVNeo. In AVNeo-patients, peak (10.6 ± 3.1 mmHg vs 22.7 ± 11 mmHg, P< 0.001) and mean pressure gradients (5.9 ± 2 mmHg vs 13.8 ± 7.3 mmHg, P < 0.001) were significantly lower and the orifice area significantly larger (2.9 ± 0.8 cm2 vs 1.9 ± 0.7 cm2, P < 0.001) compared to repair. CONCLUSIONS Compared to AV-repair, patients AVNeo showed lower mean pressure gradients and larger orifice areas at discharge. The functional result was not different.
  • Publisher: Oxford University Press
  • Language: English
  • Identifier: ISSN: 1569-9285
    ISSN: 1569-9293
    EISSN: 1569-9285
    DOI: 10.1093/icvts/ivac226
    PMID: 36018270
  • Source: Geneva Foundation Free Medical Journals at publisher websites
    PubMed Central
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