VD21 VALVE SPARING PROCEDURE IN BICUSPID AORTIC VALVE

Abstract

We present a valve sparing operation performed in a 48-year-old male patient with a bicuspid aortic valve, moderate central regurgitation and 50 mm ascending aorta aneurysm. Cardiopulmonary bypass was established by aortic arch and right atrium cannulation, the antegrade crystalloid cardioplegia was administered. The aortic valve was exposed and a fusion between the two coronary cusps identified (Sievers type 1). We decided for a shaving resection of the median raphe with a free edge leaflet reinforcement by Gore-tex 6/0 continuous suture. The valve was then reimplanted in a 30 mm Valsalva graft conduit. The procedure was finally completed with reimplantation of the coronary ostia and distal anastomosis, performed with the interposition of two teflon felts. Intraoperative transesophageal echocardiogram confirmed the good surgical result. The patient was discharged a week later with no major post-operative events and a trivial aortic insufficiency at the trans-thoracic echocardiography.