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Longer-term Outcomes after Bicuspid Aortic Valve Repair in 142 Patients
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  • Mojyan Safari,
  • Nadejda Monsefi,
  • Afsaneh Karimian-Tabrizi,
  • Aleksandra Miskovic,
  • A Vanlinden,
  • Anton Moritz,
  • Thomas Walther,
  • Tomas Holubec
Mojyan Safari
Hospital of the Goethe University Frankfurt
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Nadejda Monsefi
University Hospital Bonn
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Afsaneh Karimian-Tabrizi
Hospital of the Goethe University Frankfurt
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Aleksandra Miskovic
Hospital of the Goethe University Frankfurt
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A Vanlinden
Hospital of the Goethe University Frankfurt
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Anton Moritz
Hospital of the Goethe University Frankfurt
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Thomas Walther
Hospital of the Goethe University Frankfurt
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Tomas Holubec
Hospital of the Goethe University Frankfurt
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Abstract

Background The aim of this study was to evaluate the longer-term results of bicuspid aortic valve (BAV) repair with or without aortic root replacement. Methods From 1999 to 2017, 142 patients with or without aortic root dilatation who underwent repair of a regurgitant BAV were included in the study. Ninety-four patients underwent isolated BAV repair (Group 1; mean age 45±14 years) and 48 patients underwent valve-sparing aortic root replacement plus BAV repair (aortic valve reimplantation – Group 2; mean age 49±13 years. Median follow-up time was 5.9 years (range 0.5-15) in Group 1 and 3 years (range 0.5-16) in Group 2, respectively. Results In-hospital mortality was 1% in group 1, and 2% in Group 2 (p=0.6). The 5- and 10-year survival was 93±2.9% and 81±5.8% in Group 1 and 96±3.1% and 96±3.1% in Group 2, respectively (p=0.31). Eleven patients of Group 1 (1.7% /patient-year) and 5 patients of Group 2 (2.2%/patient-year) underwent reoperation of the aortic valve (p=0.5). The 5- and 10-year freedom from reoperation were 93.0±2.1% and 77.1±7.1% in Group 1 and 93.0±5.0% and 76.7±9.6% in Group 2 (p=0.83), respectively. At latest follow-up only 2 patients of Group 1 and 1 patient of Group 2 had AR=2° (p=0.7). The cumulative linearized incidence of all valve-related complications (bleeding, stroke, endocarditis, reoperation) was 2.9%/patient-year in Group 1 and 4%/patient-year in Group 2, respectively (p=0.6). Conclusions Isolated BAV repair and combined aortic valve reimplantation plus BAV repair provide good clinical longer-term outcomes with relatively low reoperation rate and durable valve function.

Peer review status:ACCEPTED

24 Jun 2021Submitted to Journal of Cardiac Surgery
25 Jun 2021Submission Checks Completed
25 Jun 2021Assigned to Editor
25 Jun 2021Reviewer(s) Assigned
14 Jul 2021Review(s) Completed, Editorial Evaluation Pending
15 Jul 2021Editorial Decision: Revise Major
29 Jul 20211st Revision Received
04 Aug 2021Assigned to Editor
04 Aug 2021Submission Checks Completed
04 Aug 2021Reviewer(s) Assigned
17 Aug 2021Review(s) Completed, Editorial Evaluation Pending
18 Aug 2021Editorial Decision: Revise Minor
22 Aug 20212nd Revision Received
23 Aug 2021Submission Checks Completed
23 Aug 2021Assigned to Editor
26 Aug 2021Reviewer(s) Assigned
06 Sep 2021Review(s) Completed, Editorial Evaluation Pending
06 Sep 2021Editorial Decision: Accept