Abstract
Background: Bicuspid aortic valve (BAV) is the most common
congenital heart defect and it is responsible for an increased risk of
developing aortic valve and ascending aorta complications. In case of
mild to moderate BAV disease in patients undergoing supracoronary
ascending aorta replacement, it is unclear whether a concomitant aortic
valve replacement should be performed.
Methods: From June 2002 to January 2020, 75 patients with
mild-to-moderate BAV regurgitation (± mild-to-moderate stenosis) who
underwent isolated supracoronary ascending aorta replacement were
retrospectively analyze. Clinical and echocardiographic follow-up was
100% complete (mean: 7.4±3.9 years, max 16.4). Kaplan Meier estimates
were employed to analyze long-term survival. Cumulative incidence
function for time to re-operation, recurrence of aortic regurgitation
(AR)≥3+ and aortic stenosis (AS) greater than moderate, with death as
competing risk, were computed.
Results: There was no hospital mortality and no cardiac death
occurred. Overall survival at 12 years was 97.4±2.5%, 95% CI
[83.16-99.63]. At follow-up there were no cases of aortic root
surgery whereas 3 patients underwent AV replacement. At 12 years the CIF
of reoperation was 2.6±2.5%, 95% CI [0.20-11.53]. At follow up, AR
3+/4+ was present in 1 pt and AS greater than moderate in 3. At 12 years
the CIF of AR>2+/4+ was 5.1±4.98% and of
AS>moderate 6.9±3.8%.
Conclusions: In our study mild to moderate regurgitation of a
BAV did not significantly worse at least up to 10 years after isolated
supracoronary ascending aorta replacement.
Abstract word count: 234