Cirugía en pacientes con valvulopatía aórtica bicúspide versus tricúspide: características quirúrgicas y resultados a medio plazo

Background and aim

To determine differences in surgical procedures and clinical characteristics at the time of surgery between native tricuspid aortic valves (TAV) and bicuspid aortic valves (BAV).

Methods

429 adult patients who underwent aortic valve surgery ± ascendant aortic surgery ± coronary artery bypass grafting from September 2019 to September 2023 were retrospectively reviewed.

Results

Among the 429 patients, 298 (69.5%) had TAV and 131 had BAV (30.5%). BAV patients were significantly younger at the time of surgery than TAV patients (mean age 55.3 ± 10.6 years vs. 67.6 ± 9.2 years, P < .0001). BAV patients received more combined surgery of the aorta than TAV patients (33.6% vs 12.1%, P < .0001). In terms of surgical procedures, BAV patients received a significant higher percentage of isolated aortic valve repair and aortic root remodeling than TAV patients (13.0% and 6.1% versus 3.4% and 3.0%, respectively, P <. 0001). Global in-hospital mortality was 3.7% (BAV 0%, TAV 5.4%, P = .007). Overall 5-year mortality for TAV and BAV patients was 80.3% and 97.3%, respectively (P = .0003).

Conclusions

Compared with TAV patients, those with BAV represent a lower surgical risk profile subgroup of patients. Clinical and anatomical characteristics of BAV patients explain the higher percentages of surgical aortic valve/root repair techniques received and their better early and mid-term survival outcome.