Boston - American Association for Thoracic Surgery

89 TH ANNUAL MEETING MAY 9–MAY 13, 2009BOSTON, MASSACHUSETTS30. Valve Repair for Regurgitant Bicuspid Aortic Valves: A SystematicApproachMunir Boodhwani, † Laurent de Kerchove, David Glineur, Robert Verhelst,Jean Rubay, Christine Watremez, Pasquet Agnes, Philippe Noirhomme,Gebrine El KhouryCardiovascular and Thoracic Surgery, Cliniques Universitaires Saint Luc, Brussels,BelgiumInvited Discussant: Hartzell V. SchaffOBJECTIVE: Young patients with bicuspid aortic valves (AV) can present withaortic insufficiency (AI) due to disease of the leaflet or of the aortic root and functionalaortic annulus. Valve repair is emerging as an attractive and feasible alternativeto valve replacement for bicuspid aortic valve insufficiency. We present a singlecenter experience with a functional approach to bicuspid aortic valve repair focusingon valve assessment and systematic application of repair techniques (Figure 1).METHODS: Between 1995 and 2008, 121 consecutive patients (mean age: 44 ± 12years) with bicuspid aortic valves underwent non-emergent valve repair for isolatedAI (43%), aortic root dilatation (13%), or both (44%). Preoperative echocardiographyidentified aortic dilatation (n = 75), cusp prolapse (n = 96), and cusp restriction(n = 45) as contributory mechanisms of AI which were confirmed on surgicalinspection. Conjoint cusp raphe repair was performed in 97 patients by shaving(22%) or resection of the raphe with primary closure (60%) or pericardial patchaugmentation (18%). Cusp prolapse (n = 80) was repaired by free margin plicationand/or free margin reinforcement with PTFE suture. All patients underwent a† Resident Traveling Fellowship 2007154