Suture Annuloplasty Significantly Improves the Durability of Bicuspid Aortic Valve Repair

Abstract

Annular dilatation is a risk factor for failure after repair of regurgitant BAV. Its elimination through the use of SA significantly improves repair stability. With PTFE as material for SA optimal repair stability and minimal local complications are achieved.

Bicuspid aortic valve repair: systematic review on long-term outcomes

“…Annular diameter is an important consideration in BAV repair as many patients with bicuspid anatomy present with dilated aortic annulus (43). Therefore, patients with BAV experience good long term results with reimplantation technique, as this approach implicitly involves deep dissection to the level of the basal plane and annular reduction with placement of subannular sutures (2,3).…”

“…Therefore, patients with BAV experience good long term results with reimplantation technique, as this approach implicitly involves deep dissection to the level of the basal plane and annular reduction with placement of subannular sutures (2,3). In the remodeling technique, addition of annuloplasty (whether internal or external) and systematic assessment of cusp effective height significantly improves durability (43,44). There are numerous annuloplasty techniques described, and while the optimal annuloplasty technique has not been compared in randomized fashion, there are ample data from cohort studies to support routine use of annuloplasty in some fashion during remodeling procedures (45).…”

Isolated aortic valve repair—how to do it and long-term results: suture annuloplasty

“…Moreover, we illustrated a higher amount of completely competent aortic valves postoperatively (16). With longer follow-up and in a larger patient population we finally found an impressively improved valve stability after BAV repair (17). After PTFE annuloplasty, a freedom from reoperation of more than 95% could be achieved.…”

Regarding the Suture Annuloplasty in Bicuspid Aortic Valve

“…As we pointed out the risk appears to be limited with external application. We disagree that interference with the circumflex artery was the only complication associated with internal placement [3]. A ventricular septal defect due to erosion of the membranous septum occurred two times.…”