Preservation of the bicuspid aortic valve associated with aneurysms of the aortic root and ascending aorta.
OBJECTIVE
When the bicuspid aortic valve is associated with dilatation of the aorta, surgical repair requires correction of all the components of the aortic root. Here, we review our experience in this type of surgery.


METHODS
A descriptive and retrospective observational study was carried out to analyze morbidity and mortality in valve-sparing techniques and evaluate the medium-term durability of the aortic valve. We included all patients with a bicuspid aortic valve and dilatation of the aorta who underwent surgery with a valve-sparing technique in our center between 1999 and 2011.


RESULTS
A total of 151 patients underwent surgery. A valve-sparing technique was used in 51 patients. The mean (standard deviation) age of the patients was 51 (12) years and 92% were men. In 69% of the patients, aortic insufficiency was less than grade II and the aortic cusps showed little structural degeneration. Valve reimplantation was performed in 32 patients. There was no hospital mortality. With a median follow-up of 36 months (interquartile range, 18-45 months), none of the patients died or required reoperation, and all patients were free of aortic insufficiency greater than grade II.


CONCLUSIONS
Valve-preserving surgery in bicuspid aortic valves associated with dilatation of the aorta shows excellent short- and medium-term results in selected valves. The stabilization of all of the components of the aortic root improves the durability of the valve, and the techniques proposed are reproducible and stable in the medium-term.
Servicio de Cirugía Cardiaca, Hospital Universitario 12 de Octubre, Madrid, Spain; Servicio de Cirugía Cardiaca, Hospital Universitario Quirón, Madrid, Spain. Electronic address: apforteza@yahoo.es.
Alberto
A
Forteza
Servicio de Cirugía Cardiaca, Hospital Universitario 12 de Octubre, Madrid, Spain.
Francisco
F
Vera
Servicio de Cirugía Cardiaca, Hospital Universitario 12 de Octubre, Madrid, Spain; Servicio de Cirugía Cardiaca, Hospital Universitario Quirón, Madrid, Spain.
Jorge
J
Centeno
Servicio de Cirugía Cardiaca, Hospital Universitario 12 de Octubre, Madrid, Spain.
María Jesús
MJ
López-Gude
Servicio de Cirugía Cardiaca, Hospital Universitario 12 de Octubre, Madrid, Spain.
Enrique
E
Pérez-de la Sota
Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain.
Violeta
V
Sánchez
Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain.
Beatriz
B
López-Melgar
Servicio de Cirugía Cardiaca, Hospital Universitario Quirón, Madrid, Spain.
Juan J
JJ
Rufilanchas
Servicio de Cirugía Cardiaca, Hospital Universitario 12 de Octubre, Madrid, Spain.
Jose
J
Cortina
D000328:Adult; D001011:Aorta / Q000601:surgery*; D001014:Aortic Aneurysm / Q000601:surgery*; D001021:Aortic Valve / Q000002:abnormalities* / Q000601:surgery; D001022:Aortic Valve Insufficiency / Q000209:etiology / Q000601:surgery; D000082882:Bicuspid Aortic Valve Disease; D005260:Female; D006349:Heart Valve Diseases / Q000601:surgery*; D006801:Humans; D008297:Male; D012189:Retrospective Studies
AA; AI; Aneurisma; Aneurysm; AoV; BAV; Bicuspid aortic valve; Reimplante valvular; VS; Valsalva sinus; Valve reimplantation; Válvula aórtica bicúspide; aortic insufficiency; aortic valve; ascending aorta; bicuspid aortic valve