Bicuspid Aortic Valve Surgery

Aortic valve repair is typically performed for valves with aortic regurgitation through median sternotomy or minimally invasive techniques. 74 discussion s1792 9.

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Anatomic predictors of possible repair failures have been identified and solutions developed.

Bicuspid aortic valve surgery. Aortic root and ascending aorta surgery. Aortic complications after bicuspid aortic valve replacement. The bicuspid aortic valve bav is the most common congenital heart defects in humans.

Bicuspid aortic valve bav is an inherited form of heart disease in which two of the leaflets of the aortic valve fuse during development in the womb resulting in a two leaflet valve bicuspid valve instead of the normal three leaflet valve tricuspid. S1773 s1776 view in article. That said the two types of surgical treatment for bicuspid valves are aortic valve repair and aortic valve replacement.

Aortic valve repair isn t often performed to treat a bicuspid aortic valve. Patients with a bicuspid aortic valve bav frequently require surgical intervention for aortic regurgitation ar and or aneurysm. However the 2 guidelines differ with regard to the recommended threshold of aortic root or ascending aortic dilatation that would justify surgical intervention in patients with bicuspid aortic valves.

The bicuspid aortic valve bav affects 1 2 of the population and may be associated with important valvular disease and an increased risk of aortic root and or ascending aortic aneurysm and dissection. Bav is the most common cause of heart disease present at birth and affects approximately 1 3 of adults. The defective design though causes a much higher level of mechanical stress because the pressure on the valve is shared by a smaller number of leaflets.

Valve preserving surgery and repair of regurgitant bavs have evolved into an increasingly used alternative to replacement. During an aortic valve repair the leaflets can be reshaped to open and close better. This is based on a consensus of expert opinion as data are limited for this statement.

To repair an aortic valve surgeons may separate valve flaps cusps that have fused or reshape or remove excess valve tissue so that the cusps can close tightly. In patients with a bicuspid aortic valve planned for surgical aortic valve replacement due to severe aortic stenosis or regurgitation it is reasonable to have a surgical intervention to the ascending aorta if the ascending aorta is 4 5 cm in size. Bav aortic aneurysm and dissection occur earlier in life than when these disorders are associated with a tricuspid aortic valve tav.

Keep in mind that this deformity may function adequately for years without causing any obvious symptoms.

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