title: [Surgical treatment of congenital bicuspid aortic valve in 73 patients aged over 50 years].
abstract: OBJECTIVE
  To summarize the clinical characteristics, surgical management and postoperative complications in patients with congenital bicuspid aortic valve (CBAV) over 50 years of age.
  
  
  METHODS
  From January 2009 to September 2011, 73 CBAV patients aged 51-76 years (mean 61.8∓0.73 years) were treated in our center. Except for 1 patient who underwent Bentall surgery and another having Wheat surgery, all the patients received aortic valve replacement (AVR), including 7 with double (mitral and aortic) valve replacement (DVR), 6 with mitral valvular plasty, 11 with tricuspid valvular plasty, 8 with coronary artery bypass graft implantation, 1 with aortic-left ventricular tunnel repair, 1 with atrial maze ablation, and 1 with left atrial thrombosis removal.
  
  
  RESULTS
  Two patients died after the surgery, with a perioperative mortality rate of 2.7%. The cardiopulmonary bypass time was 78-217 min (mean 131.9 ∓6.0 min) with an aortic blocking time of 56-158 min (mean 88.2 ∓4.8 min) and total postoperative ICU time of 23.0-647.4 h (mean 97.9∓10.5 h). The postoperative complications included low heart output syndrome in 5 cases, bleeding in 4 cases, wound debridement in 4 cases, and hemodialysis due to acute renal failure in 1 case. The left ventricular end diastolic diameter reduced significantly after the surgery (52.6∓1.7 vs 43.2∓1.0, P=0.001). No significant changes were detected in the left ventricular ejection fraction (62.3∓2.5 vs 65.5∓1.3, P=0.257).
  
  
  CONCLUSIONS
  Thorough preoperative examination, preoperative risk factor assessment, timely perioperative interventions, careful evaluation of patients' tolerance of surgery, and prevention of surgical complications are essential to decrease the perioperative mortality in elderly patients with CBAV.
authors.affiliation: Guangdong Academy of Medical Sciences, Guangzhou, China. jasonwong32@hotmail.com
authors.forename: Jinsong
authors.initials: J
authors.lastname: Huang
authors.forename: Keli
authors.initials: K
authors.lastname: Huang
authors.forename: Xuhua
authors.initials: X
authors.lastname: Jian
authors.forename: Min
authors.initials: M
authors.lastname: Wu
authors.forename: Cong
authors.initials: C
authors.lastname: Lu
authors.forename: Shaoyi
authors.initials: S
authors.lastname: Zheng
mesh_terms: D000368:Aged; D001021:Aortic Valve / Q000002:abnormalities / Q000601:surgery; D000082882:Bicuspid Aortic Valve Disease; D001026:Coronary Artery Bypass; D005260:Female; D006349:Heart Valve Diseases / Q000401:mortality / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery; D011183:Postoperative Complications / Q000517:prevention & control*; D012189:Retrospective Studies