AVNeo improves early haemodynamics in regurgitant bicuspid aortic valves compared to aortic valve repair.

Prinzing, Anatol; Böhm, Johannes; Sideris, Konstantinos; Vitanova, Keti; Lange, Rüdiger; Krane, Markus

doi:10.1093/icvts/ivac226

journal article

Title:: AVNeo improves early haemodynamics in regurgitant bicuspid aortic valves compared to aortic valve repair.
Document type:: Journal Article
Author(s):: Prinzing, Anatol; Böhm, Johannes; Sideris, Konstantinos; Vitanova, Keti; Lange, Rüdiger; Krane, Markus
Abstract:: OBJECTIVES: Calcified or fibrotic cusps in patients with bicuspid aortic valves and aortic regurgitation complicate successful aortic valve (AV)-repair. Aortic valve neocuspidization (AVNeo) with autologous pericardium offers an alternative treatment to prosthetic valve replacement. We compared patients with regurgitant bicuspid valves undergoing AV-repair or AVNeo. METHODS: We retrospectively analysed patients with regurgitant bicuspid valves undergoing AV-repair or AVNeo. We focused on residual regurgitation, pressure gradients and effective orifice area, determined preoperatively and at discharge. RESULTS: AV-repair was performed in 61 patients (mean age: 43.2 ± 11.3 years) and AVNeo in 22 (45.7 ± 14.1). Prior to the operation patients of the AV-repair group showed severe regurgitation in 38 cases (62.3%) and moderate in 23 (37.6%); in the AVNeo group, all patients exhibited severe regurgitation. Postoperatively, 57 patients (93.4%) patients had no or mild regurgitation after AV-repair and 21 (95.4%) after AVNeo. In AVNeo-patients, peak (10.6 ± 3.1 mmHg vs 22.7 ± 11 mmHg, P< 0.001) and mean pressure gradients (5.9 ± 2 mmHg vs 13.8 ± 7.3 mmHg, P < 0.001) were significantly lower and the orifice area significantly larger (2.9 ± 0.8 cm2 vs 1.9 ± 0.7 cm2, P < 0.001) compared to repair. CONCLUSIONS: Compared to AV-repair, patients AVNeo showed lower mean pressure gradients and larger orifice areas at discharge. The functional result was not different.
Journal title abbreviation:: Interact Cardiovasc Thorac Surg
Year:: 2022
Journal volume:: 35
Journal issue:: 5
Fulltext / DOI:: doi:10.1093/icvts/ivac226
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/36018270
Print-ISSN:: 1569-9293
TUM Institution:: Klinik für Herz- und Gefäßchirurgie (Prof. Lange)
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mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Lehr- und Forschungskooperationen mit den Kliniken und Instituten am Deutschen Herzzentrum Klinik für Herz- und Gefäßchirurgie (DHM) (Prof. Krane)2022