Early results of geometric ring annuloplasty for bicuspid aortic valve repair during aortic aneurysm surgery

Autologous repair of “very asymmetric” bicuspid aortic valves using geometric ring annuloplasty

“…At the latest echocardiography follow-up, specific values for aortic regurgitation grade averaged 0.4 ± 0.8, and mean valve gradient 12.3 ± 5.9 mm Hg. 10 Thus, the concepts in this brief report supplement those in previous reports with regard to applicability of geometric ring annuloplasty in the “very asymmetric” BAV subgroup.…”

“…Longitudinal outcomes with geometric ring annuloplasty have been excellent, 10 and this approach allows routine repair of BAV defects with “very asymmetric” geometry. Although commissural angles were not specifically measured in previous studies, intermediate type BAVs and unicuspid valves accounted for approximately one-fifth of that series, and these defects frequently display 3 equal-sized sinuses.…”

Evolution of techniques for repair of intermediate-type bicuspid aortic valves

“… 26 For mitral regurgitation, the evolution toward earlier treatment of asymptomatic severe disease has occurred, largely due to the superb results of mitral valve repair and the recognition that the heart could be spared the consequences of chronic volume overload. Similarly, the emerging excellent results observed after BAV repair 11 , 12 could initiate a trend toward earlier surgical intervention for BAV insufficiency.…”

“… 9 In repairing IBAVs, surgeons must commit to either reconstructing the valve to a trileaflet anatomy or establish a well-functioning BAV. Superior event-free survival has been well documented for standard BAV repair, 10 , 11 , 12 , 13 but IBAV cases with 3 equal sinus segments have been more difficult. 7 Application of routine repair to these more complex BAV anatomies would be a useful goal, and the development of aortic ring annuloplasty 1 could help in standardizing surgical techniques.…”

Use of aortic wall patches as leaflet replacement material during aortic valve repair

“… 6 AVr also is becoming more common for insufficient aortic valves. 7 , 8 , 9 , 10 , 11 , 12 When adequate native valve leaflets exist, the current success of AVr is excellent 13 ; however, in patients with defective leaflet tissue, prosthetic valve replacement still is required. Pericardial leaflet patches have been thoroughly tested, but have almost uniformly failed.…”