The influence of Marfans and bicuspid valves on outcomes following aortic valve reimplantation

BackgroundWe analyzed our early and midterm results with aortic valve reimplantation surgery to determine the influence of Marfan syndrome and bicuspid valves on outcomes with this technique. MethodsBetween March 2004 and December 2015, 267 patients underwent aortic valve reimplantation operations. The mean diameter of the sinuses of Valsalva was 503mm and moderate/severe aortic regurgitation was present in 34.4% of these patients. A bicuspid aortic valve was present in 21% and 40% had Marfan syndrome. ResultsOverall 30-day mortality was 0.37% (1/267). Mean follow-up was 59.7 +/- 38.7 months. Overall survival at 1, 3, and 5 years was 98 +/- 8%, 98 +/- 1%, and 94 +/- 2%, respectively. Freedom from reoperation and aortic regurgitation >II was 99 +/- 5%, 98 +/- 8%, 96.7 +/- 8%, and 99 +/- 6%, 98 +/- 1%, 98 +/- 1%, respectively at 1, 3, and 5 years follow-up, with no differences between Marfan and bicuspid aortic valve groups. (p=0.94 and p=0.96, respectively). No endocarditis or thromboembolic complications were documented, and 93.6% of the patients did not receive any anticoagulation therapy. ConclusionsThe reimplantation technique for aortic root aneurysms is associated with excellent clinical and functional outcomes at short and mid-term follow-up.