Patients with bicuspid aortic valve are often complicated with aortic dilatation. If the aortic valve is of good quality, aortic root replacement with aortic valve preservation is feasible. A 35-year-old male patient with bicuspid aortic regurgitation complicated with ascending aortic aneurysm underwent Remodeling+Ring (modified Yacoub) operation. Echocardiography showed that there was no aortic regurgitation on the 3rd day after operation, and the patient was discharged satisfactorily on the 6th day after operation. Remodeling+Ring surgery ensures the physiological movement of the aortic valve, solves the enlarged annulus, avoids the problems caused by valve replacement, and significantly improves the quality of life of patients, which is worth popularizing.
Objective To investigate the impact of bicuspid aortic valve (BAV) on the rate of ascending aortic diameter re-dilatation following ascending aortoplasty. Methods A retrospective analysis was performed on the clinical data of patients who underwent aortic valve replacement (AVR) combined with ascending aortoplasty at Fuwai Hospital between 2010 and 2022. The rate of ascending aortic diameter re-dilatation after remodeling was calculated and compared between patients with tricuspid aortic valve (TAV) and BAV within the longitudinal aortotomy-sandwich technique and external wrapping technique groups. We explored whether BAV affects the rate of diameter re-dilatation after remodeling. Results A total of 84 patients were included, comprising 58 males and 26 females, with a mean age of (54.30±11.36) years (range: 22-76 years). The follow-up duration for all 84 patients ranged from 18.30 to 158.83 months, with a median follow-up time of 42.82 (28.06, 103.12) months. In the longitudinal aortotomy-sandwich technique group (n=47), the rate of re-dilatation ranged from –3.08 to 5.90 mm/year, with a median rate of 0.83 (0.27, 1.44) mm/year. There was no statistical difference in the rate of ascending aortic diameter re-dilatation between patients with TAV and BAV within this group [0.65 (0.34, 1.43) mm/year vs. 0.99 (0.18, 1.44) mm/year, P=0.762]. In the external wrapping technique group (n=37), the rate of re-dilatation ranged from –3.57 to 6.61 mm/year, with a median rate of 0.35 (–0.28, 0.96) mm/year. Similarly, there was no statistical difference in the rate of ascending aortic diameter re-dilatation between patients with TAV and BAV within this group [0.33 (–0.17, 0.77) mm/year vs. 0.58 (–0.28, 1.05) mm/year, P=0.778]. Multivariate analysis revealed that age was an independent protective factor for re-dilatation after the longitudinal aortotomy-sandwich technique (P=0.019), and preoperative ascending aortic diameter was an independent risk factor for re-dilatation after the external wrapping technique (P=0.030). ConclusionBAV does not significantly affect the rate of ascending aortic diameter re-dilatation following ascending aortoplasty.