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External or subcomissural annuloplasty in bicuspid aortic valve repair: which is better?
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  • Metesh Acharya,
  • Hiwa Sherzad,
  • Sven Zhen Cian Tan,
  • Mohamad Bashir,
  • Giovanni Mariscalco
Metesh Acharya
Glenfield Hospital
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Hiwa Sherzad
Glenfield Hospital
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Sven Zhen Cian Tan
Queen Mary University of London Barts and The London School of Medicine and Dentistry
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Mohamad Bashir
NHS Wales Health Education and Improvement Wales
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Giovanni Mariscalco
Glenfield Hospital
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Abstract

Patients with a bicuspid aortic valve (BAV) are at increased risk of valvular regurgitation compared to their counterparts with a tri-leaflet aortic valve. There is now increasing emphasis to offer BAV repair to mitigate the risks of prosthesis-related complications, including thromboembolism, haemorrhage and endocarditis, as well as structural valve deterioration and future re-operation with conventional valve replacement, particularly in younger populations. Furthermore, over the preceding two decades, our greater understanding of the functional anatomy of the BAV, pathophysiological mechanisms of BAV insufficiency and the development of a functional classification of aortic regurgitation have significantly contributed to the evolution of aortic valve reconstructive surgery. In this commentary, we discuss a recent article from the Journal of Cardiac Surgery comparing external annuloplasty and subcommissural annuloplasty as techniques for BAV repair.

Peer review status:Published

11 Nov 2021Submitted to Journal of Cardiac Surgery
12 Nov 2021Assigned to Editor
12 Nov 2021Submission Checks Completed
12 Nov 2021Editorial Decision: Accept
24 Nov 2021Published in Journal of Cardiac Surgery. 10.1111/jocs.16152