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Fate of Un-replaced Sinuses of Valsalva in Bicuspid Aortic Valve Disease: Follow-up to 17 years

Fate of Un-replaced Sinuses of Valsalva in Bicuspid Aortic Valve Disease: Follow-up to 17 years. Chan Park 1 , Hector Michelena 2 , Thoralf M. Sundt 1 Divisions of Cardiovascular Surgery 1 and Cardiovascular Medicine 2 Mayo Clinic Rochester, Minnesota. Patient Characteristics.

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Fate of Un-replaced Sinuses of Valsalva in Bicuspid Aortic Valve Disease: Follow-up to 17 years

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  1. Fate of Un-replaced Sinuses of Valsalva in Bicuspid Aortic Valve Disease: Follow-up to 17 years Chan Park1, Hector Michelena2, Thoralf M. Sundt1 Divisions of Cardiovascular Surgery1 and Cardiovascular Medicine2 Mayo Clinic Rochester, Minnesota

  2. Patient Characteristics

  3. Operative Results

  4. Preoperative Echo finding

  5. Outcomes • Operative mortality: 2.8% • Overall mortality: 28/218 (12.8%) • Cause of death Cardiac 5/28 (17.9%) Non-cardiac 11/28 (39.3%) Unknown 12/28 (42.9%)

  6. Reoperation • Reoperation: 10/218 (4.6%) • Indication Aortic root dilation (1) Ascending aorta dilatation (2) PVE (3) PPM (2) Others (4)

  7. Details for Reoperations

  8. Survival Freedom from Reoperation 100 80 60 Probability (%) 40 1 year probability: 97.6% 5 year probabilitiy: 94.9% 10 year probability: 85.5% 20 0 0 2 4 6 8 10 Follow-up (years)

  9. Univariate Analysis for Overall Survival

  10. Multivariate Analysis for Overall Survival

  11. Size (mm) Annulus Sinus STJ AscAo Change of Aortic Size at 5 years (n= 28) * † * * p<0.05 preop vs postop, †p<0.001 preop vs postop

  12. Conclusions • The sinuses of Valsalva rarely dilate significantly after AVR and aortic repair • Separate valve and graft remains a reasonable option in the absence of significant root dilatation • The ascending aorta remains at risk of late dilatation if treated with aortoplasty

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