[Valve repair surgery for incompetent bicuspid aortic valves].
BACKGROUND
Surgical valve repair is a good alternative for correction of incompetent bicuspid aortic valve.


OBJECTIVE
To report the early and late surgical, clinical and ecochardiographic results of surgical repair of incompetent bicuspid aortic valves.


METHODS
Retrospective review of medical records of 18 patients aged 19 to 61 years, with incompetent bicuspid aortic valve in whom a valve repair was performed. Four patients had infectious endocarditis and 17 were in functional class I or II. Follow up ranged from 3 to 113 months after surgery.


RESULTS
A triangular resection of the prolapsing larger cusp, which included the middle raphe, was performed in 17 cases; in 13 of these, a complementary subcommisural annuloplasty was performed. In the remaining case, with a perforation of the non-coronary cusp, a pericardial patch was implanted; this procedure was also performed in 2 other cases. In 3 cases large vegetations were removed. Postoperative transesophageal echocardiography showed no regurgitation in 11 patients (62%) and mild regurgitation in 7 (38%). There was no operative morbidity or mortality. There were no deaths during the follow-up period. In 3 patients (17%) the aortic valve was replaced with a mechanical prosthesis, 8 to 108 months after the first operation. Reoperation was not needed in 93%+/-6,4% at 1 year and 85%+/-9,5% at 5 years, these patients were all in functional class I at the end of the follow-up period. 60% had no aortic regurgitation, 20% had mild and 20% moderate aortic regurgitation on echocardiographic examination. A significant reduction of the diastolic diameter of the left ventricle was observed, but there were no significant changes in systolic diameter or shortening fraction.


CONCLUSIONS
Surgical repair of incompetent bicuspid aortic valves has low operative morbidity and mortality and has a low risk of reoperation.
Zalaquett
Ricardo
R
Departamento de Engermedades Cardiovasculares, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago de Chile. rzalaque@med.puc.cl
Camplá
Cristóbal
C
Scheu
Maximiliano
M
Córdova
Samuel
S
Becker
Pedro
P
Morán
Sergio
S
Irarrázaval
Manuel J
MJ
Baeza
Cristian
C
Arretz
Claudio
C
Braun
Sandra
S
Chamorro
Gastón
G
Godoy
Iván
I
Yáñez
Fernando
F
D000328:Adult; D001021:Aortic Valve / Q000002:abnormalities / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000209:etiology / Q000601:surgery*; D004452:Echocardiography; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D018709:Statistics, Nonparametric; D016896:Treatment Outcome