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Long-Term Durability of Bicuspid Aortic Valve Repair

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Presentation on theme: "Long-Term Durability of Bicuspid Aortic Valve Repair"— Presentation transcript:

1 Long-Term Durability of Bicuspid Aortic Valve Repair
Lars G. Svensson, MD, PhD, Adil H. Al Kindi, MD, Alessandro Vivacqua, MD, Gösta B. Pettersson, MD, PhD, A. Marc Gillinov, MD, Tomislav Mihaljevic, MD, Eric E. Roselli, MD, Joseph F. Sabik, MD, Brian Griffin, MD, Donald F. Hammer, MD, Leonardo Rodriguez, MD, Sarah J. Williams, MS, Eugene H. Blackstone, MD, Bruce W. Lytle, MD  The Annals of Thoracic Surgery  Volume 97, Issue 5, Pages (May 2014) DOI: /j.athoracsur Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 Surgical technique for repair of bicuspid aortic valve. (A) Repair sutures for most repairs. (B) Mobilization of commissures for a large root. (C) Closure of gaps in aortic root. (D) Reattachment of commissures resuspended at a higher level in ascending aorta tube graft. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 Freedom from aortic valve reoperation after repair of bicuspid aortic valve. Each symbol (○) represents a reoperation positioned nonparametrically, vertical bars are confidence limits equivalent to ±1 standard error, and numbers in parentheses are patients still alive. Solid line is parametric estimate enclosed within dashed 68% confidence band equivalent to ±1 standard error. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

4 Fig 3 Reasons for reoperation and the reoperative procedures performed. (AR = aortic regurgitation; AS = aortic stenosis; AVR = aortic valve replacement; CABG = coronary artery bypass grafting; MVR = mitral valve replacement.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

5 Fig 4 Aortic valve regurgitation (AR) across time after aortic valve repair. Circles represent grouped data without regard to repeated measurements. Solid lines are model-based estimates that account for repeated measurements. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

6 Fig 5 Aortic valve (AV) gradient after repair of bicuspid aortic valve disease. Circles represent grouped data without regard to repeated measurements. Solid lines are model-based estimates. Preoperative (Preop) values shown as a bold dot. (A) Mean gradient. (B) Peak gradient. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

7 Fig 6 Left ventricular (LV) mass index after aortic valve repair for bicuspid disease. Circles represent grouped data without regard to repeated measurements. Solid line is model-based estimate. Late increase in LV mass index is about 0.85 g/m2 per year. Preoperative (Preop) value shown as a bold dot. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

8 Fig 7 Survival after aortic valve repair for bicuspid aortic valve disease. Each symbol (○) represents a death positioned nonparametrically, vertical bars are confidence limits equivalent to ±1 standard error, and numbers in parentheses are patients still alive. Solid line is parametric estimate enclosed within dashed 68% confidence band equivalent to ±1 standard error. Dash-dot-dash line represents survival of an age-sex-race–matched US population life table. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

9 Fig 8 Survival stratified by New York Heart Association (NYHA) functional class. Each symbol represents a death positioned on a vertical axis by the Kaplan-Meier estimator, vertical bars are 68% confidence limits equivalent to ±1 standard error, and numbers in parentheses are number of patients still alive and being traced. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions


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