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- W2019470844 abstract "Despite their overall low incidence, unicuspid valves (one commissure [dashed arrow], two raphes [full arrows], pre-op TEE) are frequent in very young patients with significant aortic valve disease (< 35 years) and present a surgical challenge. Valve repair, which consists of transforming it into a symmetrical bicuspid valve using autologous pericardium, offers the opportunity of delaying replacement. We herein examine our initial experience using this technique to evaluate the technical feasibility and early clinical and echocardiographic results. From June 2012 to December 2013, 7 patients (age: 5 to 25 years) underwent bicuspidization of a dysfunctional unicuspid valve (mean follow-up 1±0.6 years). Aortic regurgitation was the main indication for surgery for all patients (grade 3-4/4). Two patients had concomitant aortic stenosis. Three patients (43%) underwent previous percutaneous valvuloplasty. Four patients (57%) had concomitant ascending aortic replacement (aorta >45mm). All patients had a transthoracic echocardiography before discharge. In all cases, >50% of the valve surface was preserved and the diseased portion replaced with autologous pericardium, to create 2 diametrically opposed commissures and 2 symmetrical cusps (dashed arrows, post-op TEE). The procedure was technically successful in all patients. There were no perioperative mortalities. One patient had a parietal stroke with full recovery. There were no other complications. On pre-discharge transthoracic echocardiography, no patients had ≥1/4 aortic regurgitation. Median mean gradient of 19 mmHg (range 12-35 mmHg) and median peak gradient was 30.3 mmHg (range 22-46mmHg). Median aortic valve area was 1.95 cm2 (range 1.1-2.4 cm2). At last follow-up, all patients were in NYHA class 1. Bicuspidization of the unicuspid aortic valve is a safe and reproducible operation in young patients with encouraging short-term clinical and echocardiographic results. Continued technical improvements and longer term follow-up will determine the potential benefit of this approach in delaying replacement and the need for anticoagulation in this young patient population." @default.
- W2019470844 created "2016-06-24" @default.
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- W2019470844 date "2014-10-01" @default.
- W2019470844 modified "2023-09-25" @default.
- W2019470844 title "A NOVEL APPROACH FOR THE SURGICAL MANAGEMENT OF UNICUSPID AORTIC VALVES: TECHNICAL FEASIBILITY AND EARLY ECHOCARDIOGRAPHIC Results" @default.
- W2019470844 doi "https://doi.org/10.1016/j.cjca.2014.07.384" @default.
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