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Sinus Plication to Improve Valve Configuration in Bicuspid Aortic Valve Repair

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Sinus Plication to Improve Valve Configuration in Bicuspid Aortic Valve Repair
Ulrich Schneider, MD, Wolfram Schmied, Dipl-Psych, Diana Aicher, MD, Christian Giebels, MD, Lena Winter, MD, Hans-Joachim Schäfers, MD
Dept. of Thoracic and Cardiovascular Surgery, Saarland University Medical Center, Homburg/Saar, Germany

 

Background

-Bicuspid aortic valve (BAV) is the most common cardiac anomaly (1-2%; Ward, Heart 2000)
-Repair of regurgitant BAV proposed as alternative to replacement (Cosgrove, JTCVS 1991)
-Mid- and long-term stability of BAV suboptimal (Casselman, EJCTS 1999; Boodhwani, JTCVS 2010; Aicher, Circulation 2011)
-Valve anatomy identified as predictor of failure (Aicher, Circulation 2011)
-In particular commissural orientation < 160° (Aicher, Circulation 2011)
 

Hypothesis

Reducing the circumference of the fused sinuses should improve valve configuration and thus repair stability. This avoids the need for root replacement.

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