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Joel Price, Laurent De Kerchove , David Glineur and Gebrine El Khoury

Bicuspid Aortic Valve Impacts the Incidence of Induced Leaflet Prolapse and Leaflet Repair Following Aortic Valve-Sparring Root Reconstruction for Aortic Root Aneurysm. Joel Price, Laurent De Kerchove , David Glineur and Gebrine El Khoury

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Joel Price, Laurent De Kerchove , David Glineur and Gebrine El Khoury

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  1. Bicuspid Aortic Valve Impacts the Incidence of Induced Leaflet Prolapse and Leaflet Repair Following Aortic Valve-Sparring Root Reconstruction for Aortic Root Aneurysm Joel Price, Laurent De Kerchove, David Glineur and Gebrine El Khoury CliniquesUniversitaires Saint Luc, Brussels, Belgium

  2. Background • Reimplantation AVSRR is the gold-standard treatment for aortic root aneurysm with normal aortic leaflets • Numerous techniques are described • All change the native geometry of the functional aortic annulus • This can potentially result in leaflet prolapse and aortic insufficiency

  3. Purpose • To define the incidence of induced aortic valve dysfunction following AVSRR for root aneurysm in the absence of AI • The incidence of induced AI my be different in bicuspid vs tricuspid valves

  4. Methods • Retrospective study • 1996-2010: 69 patients (14.3%) underwent AVSRR for aneurysm without significant AI (≤ 1+) • Subgroup analysis for bicuspid vs tricuspid

  5. End Points • Incidence of aortic leaflet repair • Need for reinstitution of CPB • increased AI compared to preoperative • Combined endpoint

  6. Combined End-Point P< 0.001 %

  7. AI at Discharge P=0.6 %

  8. Midterm Freedom from AI

  9. Conclusions • AVSRR performed for root aneurysm without AI can induce leaflet prolapse and AI • Bicuspid aortic valves are particularly susceptible to induced prolapse and concomitant leaflet repair is very frequently required • Induced prolapse in tricuspid valves is uncommon • Surgeons must be prepared to perform concomitant leaflet repair during AVSRR

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