title: Valve cuspidity: a risk factor for aortic valve repair?
abstract: BACKGROUND
  The aim of this study was to analyze short- and mid-term results after aortic valve (AV) repair with particular regard to the impact of valve cuspidity (bicuspid versus tricuspid aortic valve).
  
  
  METHODS
  One hundred patients with aortic regurgitation (AR) undergoing aortic valve repair between November 2007 and October 2012 were included in the study. Sixty patients had bicuspid AV (BAV group; 11 females) and 40 patients had tricuspid AV (TAV group; 13 females). AR > grade 2 was present in 47 (78%) patients in the BAV and in 35 (88%) patients in the TAV group. Follow-up was complete in 100% and median was 25 months.
  
  
  RESULTS
  Isolated aortic valve repair was performed in 27 (45%) of BAV patients and in six (15%) of TAV patients. Replacement of the ascending aorta and/or aortic root was performed in 33 (55%) of BAV patients and in 34 (86%) of TAV patients. There was no death within 30 days postoperatively, while two patients died (TAV group) during the follow-up period. There was no statistical difference between BAV and TAV groups with regard to the survival (100 ± 0% vs. 95 ± 4%, p = 0.102), the three-year freedom from AV-related reoperation (90 ± 5% vs. 89 ± 6%, p = 0.456), and the three-year freedom from AR grade > 2 (86 ± 6% vs. 82 ± 7%, p = 0.866), respectively.
  
  
  CONCLUSIONS
  This study demonstrates no difference in mid-term results after regurgitant bicuspid and tricuspid aortic valve repair, suggesting that bicuspid valve may not be a risk factor for aortic valve repair.
authors.affiliation: Department of Cardiac Surgery, Charles University in Prague, Faculty of Medicine and University Hospital, Hradec Kralove, Czech Republic; Division of Cardiovascular Surgery, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Tomas
authors.initials: T
authors.lastname: Holubec
authors.forename: Pavel
authors.initials: P
authors.lastname: Zacek
authors.forename: Mostafa
authors.initials: M
authors.lastname: Jamaliramin
authors.forename: Maxmilian Y
authors.initials: MY
authors.lastname: Emmert
authors.forename: Martin
authors.initials: M
authors.lastname: Tuna
authors.forename: Pavel
authors.initials: P
authors.lastname: Nedbal
authors.forename: Jan
authors.initials: J
authors.lastname: Dominik
authors.forename: Jan
authors.initials: J
authors.lastname: Harrer
authors.forename: Volkmar
authors.initials: V
authors.lastname: Falk
authors.forename: Jan
authors.initials: J
authors.lastname: Vojacek
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001021:Aortic Valve / Q000002:abnormalities; D001022:Aortic Valve Insufficiency / Q000601:surgery*; D000082882:Bicuspid Aortic Valve Disease; D013504:Cardiovascular Surgical Procedures; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014261:Tricuspid Valve; D055815:Young Adult