Bicuspid aortic root spared during ascending aorta surgery: an update of long-term results.

BACKGROUND: Bicuspid aortic valve (BAV) aortopathy is well known in literature even if only few data exist regarding isolated supra-coronary aneurysm with normally functioning valve and root. Aim of this study is to clarify the long-term fate of bicuspid aortic root spared at the time of ascending aorta surgery.

METHODS: We identified forty-seven patients (mean age, 57±11 y; range, 35-81 y, 31 males) who were treated by means of supracoronary aortic replacement in presence of normally functioning BAV and not significantly enlarged sinues of Valsalva. Clinical follow-up (mean 93±50 months; range, 21-207) was 98.9% complete.

RESULTS: Freedom from cardiac death at 5- and 10-year was 95%±5% and 83%±16%. Three surviving patients required reoperation for the development of aortic insufficiency [2 cases treated by aortic valve replacement (AVR)] or for progression of aortic stenosis (AS) [1 case treated by transcatheter aortic valve implantation (TAVI)]. Freedom from new procedure on aortic valve was 100% and 94.4%±5.6% at 5- and 10-year. Composite event-free survival at 5- and 9-year was 82%±18% and 69%±30%.

CONCLUSIONS: Although in the setting of a BAV, aortic root integrity seems to remain stable during long term follow up with low rate of reoperation and occurrence of new adverse event.