REPAIR OF INSUFFICIENT BICUSPID AORTIC VALVES

technique for the repair of bicuspid aortic valves that includes resec tion of the flail segment of the prolapsing leaflet, annuloplasty, and resection of the raphe, when present, has been reported. To assess th e efficacy of this technique in the repair of insufficient bicuspid ao rtic valves, the results in 72 consecutive patients were assessed. The mean age of the patients was 39 +/- 11 years; 94% were male. Fifty-si x patients (78%) underwent isolated aortic valve repair, 9 (12.5%) und erwent aortic and mitral valve repair, and 7 (9.7%) had other associat ed procedures. All patients underwent leaflet resection, including 35 (48%) at the raphe. The mean aortic occlusion time was 39 +/- 12 minut es. There were no operative deaths. The severity of aortic insufficien cy, as assessed by Doppler echocardiography (graded from 0 to 4) preop eratively and intraoperatively and at late follow-up, was 3.6 +/- 0.6, 0.4 +/- 0.4, and 0.9 +/- 0.8, respectively, with a p value of < 0.000 1 for the latter two values versus the preoperative one. There have be en no postoperative deaths, Patients did not receive anticoagulation t reatment and there were no strokes or episodes of endocarditis. Six pa tients have required reoperation; 3 underwent repeat repair. The Kapla n-Meier freedom from aortic valve reoperation probabilities at 22 and 24 months were 94% and 89.5%, respectively. We conclude that valvulopl asty for insufficient bicuspid aortic valves is technically safe, is a ssociated with a low incidence of recurrent insufficiency, and has bee n associated with no other valve-related complications.