Aortic valve reconstruction with use of pericardial leaflets in adults with bicuspid XXXX : early and midterm outcomes.

@entity4503 @entity1 @entity886 @entity337
In this study, we retrospectively analyzed the outcomes of adults with @entity4503 who underwent @entity886 ( @entity886 ), consisting of replacement of the diseased BAV with 2 or 3 pericardial leaflets plus fixation of the sinotubular junction for accurate and constant leaflet coaptation. From December 2007 through April 2013, 135 consecutive @entity1 (mean age, 49.2    13.1 yr; 73.3% @entity1 ) with symptomatic @entity4503 underwent @entity886 . Raphe was observed in 84 @entity1 (62.2%), and the remaining 51 @entity1 had pure BAV without raphe. A total of 122 @entity1 (90.4%) underwent 3-leaflet reconstruction, and 13 (9.6%) underwent 2-leaflet reconstruction. Concomitant aortic wrapping with an artificial graft was performed in 63 @entity1 (46.7%). There were no in-hospital deaths and 2 late deaths (1.5%); 6 @entity1 (4.4%) needed valve-related reoperation. The 5-year cumulative survival rate was 98%    1.5%, and freedom from valve-related reoperation at 5 years was 92.7%    3.6%. In the last available echocardiograms, @entity337 was absent or trivial in 116 @entity1 (85.9%), mild in 16 (11.9%), moderate in 2 (1.5%), and severe in one (0.7%). The mean aortic valve gradient was 10.2    4.5 mmHg, and the mean aortic valve orifice area index was 1.3    0.3 cm(2)/m(2). The 3-leaflet technique resulted in lower valve gradients and greater valve areas than did the 2-leaflet technique. Thus, in @entity1 with BAV, @entity886 yielded satisfactory early and midterm results with low mortality rates and low reoperation risk after the initial procedure.
