title: Reconstruction of bicuspid aortic valve with autologous pericardium--usefulness of tricuspidization.
abstract: BACKGROUND
  This study describes the surgical treatment of bicuspid aortic valve with original aortic valve reconstruction.
  
  
  RESULTS
  Aortic valve reconstruction was done in 102 patients with bicuspid aortic valve from April 2007 through September 2011. Thirty-four patients with ascending aortic diameter >45 mm underwent hemi-arch aortic replacement concomitantly. Seventy-seven patients had aortic stenosis, and 25 had aortic regurgitation (AR). Mean age was 63.7±10.0 years old. There were 55 men and 47 women. Harvested pericardium is treated with 0.6% glutaraldehyde solution. The distance between commissures is measured with an original sizing instrument. For bicuspid valve with raphe, the raphe is considered as a commissure in order to measure the distance between each commissure. Without a raphe, we create a new annular margin and commissure using coronary ostium and the sizing instrument as a guide. Then, pericardium is trimmed with original template. Three cusps are sutured independently. The preoperative averaged peak pressure gradient of 71.1±39.0 mmHg was decreased to 16.2±8.8, 13.3±6.0, and 13.9±5.6 mmHg, respectively 1 week, 1 year, and 3 years after operation. AR was trivial. One reoperation was recorded. Mean follow-up was 733 days. There were 5 late mortalities. No thromboembolic event was recorded.
  
  
  CONCLUSIONS
  Medium-term results were excellent. Tricuspidization gave good opening and closure of aortic valve with excellent hemodynamics.
authors.affiliation: Department of Cardiovascular Surgery, Toho University Ohashi Medical Center.
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Ozaki
authors.forename: Isamu
authors.initials: I
authors.lastname: Kawase
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Yamashita
authors.forename: Shin
authors.initials: S
authors.lastname: Uchida
authors.forename: Yukinari
authors.initials: Y
authors.lastname: Nozawa
authors.forename: Mikio
authors.initials: M
authors.lastname: Takatoh
authors.forename: So
authors.initials: S
authors.lastname: Hagiwara
authors.forename: Nagaki
authors.initials: N
authors.lastname: Kiyohara
mesh_terms: D000368:Aged; D001021:Aortic Valve / Q000002:abnormalities* / Q000601:surgery; D001022:Aortic Valve Insufficiency / Q000473:pathology / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000473:pathology / Q000601:surgery*; D000082882:Bicuspid Aortic Valve Disease; D006348:Cardiac Surgical Procedures / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010496:Pericardium