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Functional Outcomes of Type I Bicuspid Aortic Valve Repair With Annular Stabilization: Subcommissural Annuloplasty Versus External Subannular Aortic Ring 

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Presentation on theme: "Functional Outcomes of Type I Bicuspid Aortic Valve Repair With Annular Stabilization: Subcommissural Annuloplasty Versus External Subannular Aortic Ring "— Presentation transcript:

1 Functional Outcomes of Type I Bicuspid Aortic Valve Repair With Annular Stabilization: Subcommissural Annuloplasty Versus External Subannular Aortic Ring  Hanjo Ko, MD, Joseph E. Bavaria, MD, Andreas Habertheuer, MD, PhD, John G. Augoustides, MD, Mary A. Siki, BS, Melanie Freas, DNP, CRNP, Caroline Komlo, BS, Karianna Milewski, MD, PhD, Nimesh D. Desai, MD, PhD, Wilson Y. Szeto, MD, Prashanth Vallabhajosyula, MD, MS  The Annals of Thoracic Surgery  Volume 107, Issue 1, Pages (January 2019) DOI: /j.athoracsur Copyright © 2019 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 Drawing of the functional aortic root complex. (A) Measured anatomic parameters of the aortic root, and aortic valve leaflet parameters in relation to the aortic annular plane. (B) Relationship among cusp billowing, effective coaptation height, and coaptation length in 2 different schematics. Annular stabilization can lead to improved effective height or unchanged effective height and yet improved coaptation length without changing cusp billowing. In our series with subcommissural annuloplasty and external subannular aortic ring, we noted little to no change in cusp billowing with repair, but coaptation length significantly improved. (AI = aortic insufficiency.) The Annals of Thoracic Surgery  , 68-75DOI: ( /j.athoracsur ) Copyright © 2019 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 Comparison of external subannular aortic ring versus subcommissural annuloplasty (SCA) techniques is shown. The basic technique along with the pros and cons of each surgical approach are outlined. In the external subannular aortic ring image, the white arrow marks the right coronary artery. Stars mark the subannular sutures brought through the ring to be tied down over a Hegar dilator. In the subcommissural annuloplasty image, black arrows mark the horizontal mattress stitch that is placed from one side of the commissure into the subannular interleaflet triangle, and then out from the other side of the commissure. The depth of the mattress stitch in the interleaflet triangle determines the extent of annular compression achieved at the commissure. The Annals of Thoracic Surgery  , 68-75DOI: ( /j.athoracsur ) Copyright © 2019 The Society of Thoracic Surgeons Terms and Conditions

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