Objective : In bicuspid aortic valve with pure regurgitation, if long-term aortic valve competence is achieved by aortic valve repair, it will be the best option to offer to grown-up pts because it offers the best effective orifice area with no anticoagulation. We developed a standardized technique which alleviates the technical difficulties related to these procedures.
Methods : Between December 1995 and December 2000, 15 consecutive patients underwent an aortic valve repair in relation to a bicuspid aortic valve in our institution. Their median age was 42 years (25-56 years). Fourteen had severe aortic regurgitation. In one patient who had moderate regurgitation, the primary reason for operation was severe mitral regurgitation. All patients had a resection of a median raphe and subcommissural annuloplasty. The free edges of the leaflets were reinforced with polytetrafluoroethylene sutures in 6 pts, and 4 pts with an aortic root aneurysm had a concomitant aortic root remodelling.
Results : There were no early death. Immediate postoperative echocardiography showed no residual regurgitation. After a median follow-up of 42 months (11-152 months), one pt had died of stroke and the remaining 14 pts were asymptomatic without any valve-related complications. Follow-up echocardiography showed grade II insufficiency in 1pt, grade I in 2 pts and no insufficiency in the remaining pts.
Conclusion : We developed a standardized technique of repair of bicuspid aortic valve which is simple and reproducible. The excellency of results achieved push us to extend the indications of these techniques from the grown-up to the paediatric population.