Abstract
BackgroundEvaluate the safety and efficacy of our modified technique of the extravascular procedure for treating mild to moderately dilated ascending aorta in patients with bicuspid aortic valve (BAV) aortopathy.MethodsFrom January 2015 to December 2018,119 consecutive patients with BAV and ascending aorta dilatation (dimension 40 mm~ 45 mm) were diagnosed in our institution. Among these,49 patients received aggressive aortic valve replace (AVR) + ascending aorta wrapped (wrapped group) while the other 70 patients received AVR + ascending aorta replacement (wheat group). All patients clinical and follow up data were collected for 12 months.ResultsAortic clamping and cardio-pulmonary bypass times were significantly longer in wheat group than wrap group (P < 0.001and 0.021,respectively). The first 24 h drainage in wheat group were much more than wrap group(P = 0.04). Ascending aorta diameter、left ventricular end diameter and ejection fraction were statistically different between pre- and post-operation (p < 0.001) in both groups, but the heart function and complication were no difference during follow up.ConclusionsExternal wrapping of the ascending aorta and wheat procedure have good short-term and long-term results in BAV patients with a mild to moderately dilated ascending aorta. The perioperative period results of external wrapping of the ascending aorta for BAV patients were encouraging.
Highlights
The recent survey revealed that of all the individuals with bicuspid aortic valve (BAV), 75% of BAV patients will be presenting aortic valve stenosis and dilation of the supra-coronary aorta, 15% aortic insufficiency and dilation of the proximal aortic root, leaving the fate of the remaining 10% undefined [1, 2]
BAV presents a distinct pattern of ascending aorta dilatation a phenomenon relatively well-recognized among this group of patients to be indirectly proportional to associated valvular lesions
External wrapping of the ascending aorta was performed in 45.11% (n = 49)
Summary
The recent survey revealed that of all the individuals with BAV, 75% of BAV patients will be presenting aortic valve stenosis and dilation of the supra-coronary aorta, 15% aortic insufficiency and dilation of the proximal aortic root, leaving the fate of the remaining 10% undefined [1, 2]. Recommendations for the surgical management of dilatation and aneurysm of the ascending aorta in cases of BAV associated aortopathy are clearly stated in the treatment guidelines but still void of specifics [7, 8]. This method basically involves resection and replacement of the aneurysmal aorta with a vascular graft. Evaluate the safety and efficacy of our modified technique of the extravascular procedure for treating mild to moderately dilated ascending aorta in patients with bicuspid aortic valve (BAV) aortopathy
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