Research Article
Is Conservative Repair an Acceptable Way for Treatment of the Regorgitant Bicuspid Aortic Valve
Division of Cardiovascular Surgery, Mazandaran Heart Center, Mazandaran University of Medical Sciences, Sari, Iran
From August 1997 to December 2000, 19 patients with aortic regurgitation due to congenital aortic valve underwent aortic valve repair (17 men and 2 women with a mean age of 42 ± 17 years; range, 16 to 70 years). The mean preoperative aortic regurgitation grade was 3.1 ± 0.8 on a scale of 1 to 4. Mean preoperative New York Heart Association functional class was 1.9 ± 0.8. Fourteen patients had pure aortic regurgitation, 2 also had infectious endocarditis, 1 had angina pectoris and 2 had an ascending aortic aneurysm. There was 1 hospital death (5.2%) and 1 patient required re-operation due to recurrent infectious endocarditis. Mean aortic regurgitation grade at discharge was 1.1 ± 0.9 and functional class was 1.1 ± 0.2. All patients were followed for a mean duration of 40 ± 23 months (range, 0.5 to 84 months). There was 1 late death and two patients required aortic valve replacement. The 5-year survival rate was 90 ± 7%. The 1 and 5-year re-operation-free rates were 87 ± 12 and 76 ± 23%. Bicuspid aortic valve repair is a safe procedure with good early postoperative results. However midterm results are not satisfactory. Re-operation is a promising alternative and progress aortic regurgitation were complications. Bicuspid aortic valve repair to valve replacement that requires additional study to individualize treatment.