Bicuspid aortic valve repair with an expansible ring. Even though 20year stability has been achieved in a relevant proportion of repaired bicuspid aortic. We hypothesized that adding a suture annuloplasty sa should lead to. Maxime laflamme md chirurgien cardiaque iucpq 3 octobre. Links to pubmed are also available for selected references.
We hypothesized that adding a suture annuloplasty sa should lead to improved repair stability. Bicuspid valve 0 raphe commisures 180 1 raphe commisures 120180 2 raphes aortic valve tricuspid commissures 120 unicuspid valve nclc ncrc good candidates for repair. Tte is also indicated with dilated aortic sinuses or ascending aorta or with a bicuspid aortic valve to evaluate the presence and severity of ar. Aug 01, 2017 the mitral valve is a heart valve that lies between the left atrium and left ventricle. For a bicuspid valve to coapt efficiently, the free edges of its leaflets must have the. Segmental approach to repair of regurgitant bicuspid aortic. Segmental approach to repair of regurgitant bicuspid aortic valves. Aortic diseases associated with bicuspid aortic valve. Bicuspid aortic valve is the most common congenital heart defect in adults.
Sep 20, 2016 isolated repair of the regurgitant bicuspid aortic valve bav has yielded suboptimal durability, with annular dilatation being important risk factor for recurrent aortic regurgitation. The free edges of a bicuspid valve are more straight than. Valve configuration determines longterm results after. Ac accounts for 58% of all congenital heart diseases with a maletofemale ratio of 41 but its. Over the past 15 years, improvements have been made regarding assessment of valve configuration and annular stabilization. Pdf aortic dilatation in patients with bicuspid aortic valve. In total, 4986 patients underwent aortic valve repair. Repair of the bicuspid aortic valve bav has evolved in the past. This valve can function like any other aortic valve. Aortic regurgitation canadian cardiovascular society. Chronic high blood pressure may stress the aortic tissue, making it more susceptible to tearing. It may lead to a narrowed or obstructed aortic valve opening aortic valve stenosis, making it difficult for the heart to pump blood into the aorta. Bicuspid aortic valve annals of thoracic and cardiovascular surgery. To further optimize hemodynamics, especially in small aortic annuli, livanova features in its carbomedics portfolio the top hat prosthesis, a truly totally supraannular model14 which provides an advantage of 1 to 2 sizes over intraannular valves.
Bicuspidie causes symptomes traitement pronostic prevention. Nov 19, 2018 aortic regurgitation ar is the diastolic flow of blood from the aorta into the left ventricle lv. The cleveland ciinic foundation, cleveland, ohio a. Dilatation of the proximal aorta, or bicuspid aortopathy, is present in approximately half these patients and can lead. Bicuspid aortic valves are the most common cardiac valvular anomaly, occurring in 12% of the general population. Segmental approach to repair of regurgitant bicuspid. Regurgitation is due to incompetence of the aortic valve or any disturbance of the valvular apparatus eg, leaflets, annulus of the aorta resulting in the diastolic flow of blood into the left ventricular chamber. Bicuspid aortic valve is a heritable condition, with a demonstrated association with mutations in the notch1 gene. The bicuspid design for the aortic valve is less optimal than the tricuspid one. Repair of insufficient bicuspid aortic valves charles d. Some people are born with an aortic valve that has two cusps bicuspid aortic valve instead of three. The american association for thoracic surgery consensus.
Preservation of the bicuspid aortic valve associated with. Mar 27, 2019 coarctation aortique pdf admin march 27, 2019 march 27, 2019 no comments on coarctation aortique pdf middle aortic coarctation is a rare vascular anomaly characterized by the segmental narrowing of the abdominal andor distal descending thoracic aorta with. Bicuspid aortic valve is the most common congenital heart defect in adults, affecting 1. Association of marfan syndrome and bicuspid aortic valve.
Esc guidelines on aortic diseases european society of cardiology. Methods and results twenty consecutive young adults with stenotic bicuspid aortic valves were examined with cmr and transthoracic. Suture annuloplasty significantly improves the durability of. Full text is available as a scanned copy of the original print version. Suture annuloplasty significantly improves the durability of bicuspid.
Bicuspid aortic valve was found in 4 of 89 marfan syndrome patients two males. The bicuspid aortic valve is a common congenital car diac anomaly, having. Geometry and dilatation of the aortic root and ascending aorta may provide indirect hints that a bicuspid valve may be present. Aortic regurgitation ar is the diastolic flow of blood from the aorta into the left ventricle lv. The aortic valve is a valve in the human heart between the left ventricle and the aorta. Bicuspid aortic valve bav is an inherited form of heart disease in which two of the leaflets of the aortic valve fuse during development in the womb resulting in a twoleaflet valve bicuspid valve instead of the normal threeleaflet valve tricuspid. Assessment of valvular surfaces in children with a congenital. Contemporary natural history of bicuspid aortic valve.
You can also be born with a condition associated with a weakened and enlarged aorta, such as marfan syndrome, bicuspid aortic valve or other rarer conditions associated with. Bicuspid aortic valve bav is a common cardiac anomaly that affects 0. The stabilization of all of the components of the aortic root improves the durability of the valve, and the techniques proposed are reproducible and stable in the mediumterm. Get a printable copy pdf file of the complete article 4. Bicuspid aortic valve in competitive athlete request pdf.
Additional benefits from free edge reinforcement are the stabilization of the free margin and the avoidance of recurrent cusp prolapse. Ubc medicine educational media recommended for you. Insuffisance aortique recommandations sur les pathologies valvulaires journee. Aortic valve sparing root replacement remodeling with. Pdf aortic wall elastic properties in case of bicuspid. Assessment of valvular surfaces in children with a. Bicuspid aortic valve bav disease is the most common congenital cardiac defect. Aortic coarctation ac is defined as a local narrowing of the aortic lumen, which is located at the level of the isthmus in 95% of patients i.
Ubc medicine neurology clinical skills motor, sensory, and reflex examination duration. Valvepreserving surgery in bicuspid aortic valves associated with dilatation of the aorta shows excellent short and mediumterm results in selected valves. Cosgrove iii, md department of thoracic and cardiovascular surgery and department of biostatistics. The aortoventricular junction in aortic repair emmanuel lansac, isabelle di centa cardiac surgery. Pdf aortic wall elastic properties in case of bicuspid aortic valve. The valve allows blood to flow into the left ventricle when the left atrium squeezes contracts. Repair has become an alternative to replacement for bicuspid aortic valves that require surgery for regurgitation with left ventricular volume overload or aortic aneurysm.
The pulmonary valve can also be bicuspid, although this is much rarer and is most commonly associated with congenital heart disease such as. Repair of the bicuspid aortic valve operative techniques. Nevertheless, more than 1% of the population has a bicuspid aortic valve bav, and the majority of these valves serve the owners well for life. Preliminary threedimensional echocardiographic study emconsulte. It is one of the two semilunar valves of the heart, the other being the pulmonary valve. Aortic dilatation in patients with bicuspid aortic valve. Repair of insufficient bicuspid aortic valves sciencedirect. Even though bicuspid aortic v alve bav is the most common cardiac malformation with a prevalence estimated between 0. Suture annuloplasty significantly improves the durability. Bicuspid aortic valve repair with an expansible ring cardiac surgery institut mutualiste montsouris, paris, france.
The aortic valve normally has three cusps or leaflets, although in 12% of the. Overall weighted inhospital mortality for all studies was low 1. While the bav can be found in isolation, it is often associated with other congenital cardiac lesions. Valve configuration determines longterm results after repair.
Familial bicuspid aortic valve is a rare, genetic, aortic malformation defined as a presence of abnormal twoleaflet aortic. Chromosomal and inherited syndromic thoracic aortic aneurysms and dissection. Free margin plication free margin resuspension ptfe 23 19% 72 59% cusp management. Dilatation of the proximal aorta, or bicuspid aortopathy, is present in approximately half these patients and can lead to. Isolated repair of the regurgitant bicuspid aortic valve bav has yielded suboptimal durability, with annular dilatation being important risk factor for recurrent aortic regurgitation. Recommendations on the echocardiographic assessment of. Repair of bicuspid aortic valves in patients with aortic. Jun 07, 2019 coarctation aortique pdf art june 7, 2019 middle aortic coarctation is a rare vascular anomaly characterized by the segmental narrowing of the abdominal andor distal descending thoracic aorta with. Maxime laflamme md chirurgien cardiaque iucpq 3 octobre 2015. Objective we aimed to compare velocityencoded cine cardiac magnetic resonance cmr with an established echocardiographic method for noninvasive measurement of aortic valve area ava using the continuity equation. Background bicuspid aortic valve regurgitation can be caused by a defect in the valve itself. The cleveland ciinic foundation, cleveland, ohio a technique for the repair of. Full text full text is available as a scanned copy of the original print version. The aortic valve normally has three cusps or leaflets, although in 12% of the population it is found to congenitally have two leaflets.998 130 611 1482 461 1310 1378 1400 741 1098 1579 649 93 441 1413 1557 1033 833 985 1156 1453 831 646 605 1002 233 585 603 241 987 1578 585 194 503 185 1505 1378 733 247 1087 895 492 1235 761 588 946