to analyze late outcomes and fate of aortic root in patients with bicuspid aortic valve with antero-posterior orientation (BAV-AP) and aortic dilation undergoing ascending aorta replacement extended to the non-coronary sinus (NCS) (coronary-sinus sparing technique).
clinical and echocardiographic data of patients with BAV-AP scheduled for ascending aorta and root aneurysm repair and undergone ascending aorta replacement with coronary sinus-sparing technique at a single Center between 2000 and 2013 were retrospectively reviewed. Patients undergone redo operations or emergent surgery were excluded.
69 patients (males n = 63, median age 66 years, IQ range 48–66) underwent coronary-sinus sparing technique: 50 (72%) required associated aortic valve replacement. There were no hospital deaths. Only 1 major postoperative bleeding requiring reintervention happened. At 15-years follow up (completeness 96%), 13 (19%) patients died, but only 4 (6%) due to cardiovascular deaths. Only 6 (9%) patients underwent cardiac reoperation (none for root dilation). No aortic dissections occurred. At follow up all patients are in good clinical status with only 7 (10%) patients with NYHA II-III. Echocardiographic analysis of available data showed significant reduction of root diameter after intervention, with slightly increase at follow up (Figure 1).
coronary sinus-sparing technique with ascending aorta replacement extended to NCS in patients scheduled for aortic aneurysm repair with BAV-AP and asymmetrical root enlargement is a safe and low risk procedure, with good results in terms of late survival and freedom from root reintervention. This procedure reduces preoperative root diameter, granting nearly stable results at long-term follow up.
1UOC Cardiochirurgia, Dipartimento di Scienze Cardiologiche, Toraciche e Vascolari, Università di Padova Padova
2Biostatistica, Dipartimento di Scienze Cardiologiche, Toraciche e Vascolari, Università di Padova Padova