| Author, year and country . | Demographicsa . | Study design . | Outcomesa . | Resultsa . |
|---|---|---|---|---|
| Aicher et al. (2004), Germany [15] | n = 60 Male 83.3% Mean age 53 ± 12 years Aortic dissection 6.7% | Retrospective cohort study comparing valve-sparing aortic root replacement in patients with TAV or BAV | In-hospital mortality Postoperative AI grade 5-year overall survival TE events/endocarditis during follow-up Reoperation during follow-up 5-year mean AV gradient 5-year freedom from AI > II 5-year freedom from reoperation | 0% 0.8 ± 0.7 82% 0% 1.7% 4.5 ± 2.3 mmHg 96% 98% |
| Aicher et al. (2007), Germany [16] | n = 81 Male 85.2% Aortic dissection 7.4% AI > II 55.6% Marfan 0% | Retrospective cohort study of aortic root remodelling in patients with BAV, AI and dilatation of the ascending aorta. Comparison made with patients with TAV | Hospital mortality 10-year overall survival 10-year freedom from AI > II 10-year freedom from reoperation 10-year freedom from AVR | 0% 94% 87% 97% 99% |
| Aicher et al. (2010), Germany [17] | n = 205 | Retrospective cohort study comparing AV repair in patients with BAV and TAV, limited raw data presented for BAV | 5-year freedom from AI > II 10-year freedom from AI > II | 86% 83% |
| Aicher et al. (2011), Germany [4] | n = 316 Male 84.8% Age range 3–79 years Aortic dissection 8% Severe AI 72.8% | Retrospective case series evaluating the effect of valve configuration on outcomes after repair of BAV | In-hospital mortality 10-year overall survival 10-year freedom from AI > II 10-year freedom from reoperation 10-year freedom from AVR | 0.63% 92% 81% 81% 84% |
| Alsoufi et al. (2005), Canada [18] | n = 71 Male 87.3% Mean age 41.5 ± 13.2 years | Retrospective case series of prospectively collected data on AV repair for AI secondary to BAV, aortic remodelling/ replacement included | Hospital mortality Postoperative AI > II 8-year overall survival Freedom from TE/haemorrhage 8-year freedom from reoperation 8-year freedom from endocarditis 8-year freedom from AI > II | 0% 0% 96.7% 100% 82.3% 90% 44.2% |
| Ashikhmina et al. (2010), USA [19] | n = 108 Male 91% Mean age 41 years | Retrospective case series of BAV repair. Patients with valve-sparing aortic root replacements were excluded | In-hospital mortality 10-year overall survival 10-year freedom from reoperation 10-year freedom from AVR | 0% 87% 64% 49% |
| Badiu et al. (2010), Germany [20] | n = 11 Male 100% Mean age 37 ± 15.8 years Aortic dissection 0% Marfan 0% | Retrospective cohort study comparing BAV and TAV repair for AI | Operative mortality 5-year overall survival 5-year freedom from reoperation 5-year freedom from AI 5-year freedom from TE events | 0% 100% 100% 57.1% 95.9% |
| Bakhtiary et al. (2009), Germany [21] | n = 14 Male 92.9% Mean age 58 ± 5 years AI > I 78.6% | Retrospective case series of patients undergoing the modified David procedure for incompetent BAV. | Endocarditis NE Operative death In-hospital death Late death | 0% 0% 0% 0% 0% |
| Boodhwani et al. (2009), Belgium [12] | n = 90 | Retrospective cohort study comparing aortic valve repair for AI in BAV and TAV, limited raw data presented for BAV | Comparison of freedom from AI recurrence between BAV and TAV | P = 0.7 |
| Boodhwani et al. (2010), Belgium [22] | n = 122 Male 92% Mean age 44 ± 11 years AI > II 86.1% | Retrospective case series of patients undergoing surgery for BAV in association with either AI or dilatation of the proximal aorta | In-hospital mortality Discharge AI < II 8-year overall survival 5-year freedom from AI > II 8-year freedom from AV reoperation 8-year freedom from AVR 8-year freedom from TE and bleeding | 0% 93% 97 ± 2% 94 ± 3% 83 ± 5% 90 ± 5% 96 ± 2% |
| Casselman et al. (1999), USA [23] | n = 94 Male 93% Mean age 38 ± 10 years | Retrospective case series of aortic valve repair in patients with BAV and AI | Immediate reoperation Immediate postoperative AI > II 7-year freedom from AV reoperation | 8.5% 2.1% 84% |
| Davierwala et al. (2003), Canada [24] | n = 44 Mean age 39.3 ± 12.1 years Male 93.2% Preoperative CCF 13.6% | Retrospective cohort study of prospectively collected data comparing AV repair to AVR in patients with AI caused by BAV. Procedures on the aorta were included | Operative mortality Late death TE/Haemorrhagic events 5-year freedom from AI > I 5-year freedom from AV reoperation | 0% 0% 0% 79 ± 8% 91 ± 5% |
| de Kerchove et al. (2009), Belgium [25] | n = 54 | Retrospective cohort study comparing the impact of preoperative AI on outcome after aortic valve-sparing surgery, limited raw data presented for BAV | 5-year freedom from AI > II 8-year freedom from AV reoperation | 98 ± 2% 91 ± 9% |
| Delius et al. (1998), USA [26] | n = 16 | Retrospective cohort study of aortic valve repair in patients with either subvalvular or supravalvular aortic stenosis. Comparison made between BAV and TAV | 10-year overall survival 5-year freedom from reoperation 5-year freedom from AVR | 100% 43% 43% |
| Doss et al. (2010), Germany [27] | n = 66 (A) n = 49; (B) n = 17 Mean age 41.2 ± 12 years (A) 58 years; (B) 39 yrs Male 78.8% (A) 82.3%; (B) 77.6% AI > II 95.4% (A) 82.3%; (B) 100% | Retrospective cohort study of (A) patch augmentation plus reduction aortoplasty vs (B) modified David procedure in patients with BAV and AI | 5-year mortality 5-year reoperation 5-year endocarditis 5-year conduction disturbance/thromboembolism/AI > I | (A) 2.0% (B) 0% (A) 2.0% (B) 0% (A) 2.0% (B) 0% (A) 0% (B) 0% |
| Fraser et al. (1994), USA [28] | n = 72 Male 94.4% Mean age 39 ± 11 years | Retrospective case series of AV repair for AI secondary to BAV | Operative death Late death 3-year freedom from AV reoperation | 0% 0% 89.5% |
| Kin et al. (2003), Japan [29] | n = 19 Male 98% Mean age 42 ± 17 years | Retrospective case series of AV repair for AI secondary to BAV, some patients underwent concomitant procedures on the aorta | Hospital death Early reoperation Reoperation at follow-up Late death 5-year overall survival 5-year freedom from AV reoperation | 5.2% 5.2% 15.8% 5.2% 90 ± 7% 76 ± 23% |
| Lausberg et al. (2006), Germany [30] | n = 89 n = 34; (B) n = 56 | Retrospective cohort study comparing (A) AV repair alone to (B) AV repair plus aortic root remodelling in patients with AI, limited data for BAV alone | Freedom from significant AI in (A) Freedom from reoperation in (A) | (A) 89.1% (A) 100% |
| Mangini et al. (2010), Italy [31] | n = 31 Mean age 49.9 ± 17.3 years Male 83.9% AI > I 96.8% | Prospective case series of patients undergoing repair of BAV for AI | 30-day operative mortality Discharge AI > I 5-year freedom from reoperation | 3.2% 3.2% 96.6% |
| McMullan et al. (2007), Australia [32] | n = 21 Median age 12.6 years Mean follow-up 36.4 months | Retrospective cohort study of tricuspidisation with cusp extension vs Ross procedure in children with AI or AS associated with BAV | Early reoperation Endocarditis during follow-up AVR during follow-up AI > 2 during follow-up | 9.5% 4.8% 9.5% 19.0% |
| Minakata et al. (2004), USA [14] | n = 54 | Retrospective case series of AV repair for AI, limited raw data presented for BAV | Reoperation during index admission Reoperation during follow-up 5-year reoperation rate | 3.7% 11.1% 9% |
| Moidl et al. (1995), Austria [33] | n = 14 Mean age 30.9 ± 12 years Male 92.9% Preoperative AI grade 3.5 ± 0.1 | Retrospective case series of valve-sparing correction of AI and BAV | Reoperation during index admission | 21.4% |
| Nash et al. (2004), USA [34] | n = 77 Mean age 38 ± 10 years Male 93% | Retrospective case series of the echocardiographic factors that predict successful AV repair in patients with BAV and AI | AVR during index admission Reoperation during index admission Perioperative death Thromboembolism Endocarditis | 2.6% 3.9% 0% 0% 0% |
| Odim et al. (2005), USA [35] | n = 39 | Retrospective case series of AV repair with pericardial leaflet extension | Early mortality 2-year freedom from reoperation | 2.6% 70–90% |
| Pretre et al. (2006), Switzerland [36] | n = 12 Median age 18 years Male 75% | Retrospective case series of AV repair with tricuspidization of the BAV | Postoperative morbidity AR > I | 0% 8.3% |
| Rao et al. (2000), Canada [37] | n = 23 | Retrospective case series of AV repair for multiple pathologies, limited raw data presented for BAV | Composite endpoint of reoperation or AI | No difference between BAV and TAV (P > 0.05) |
| Schafers et al. (2000), Germany [38] | n = 16 Age range 35–73 years Male 75% Aortic dissection 6.3% | Retrospective case series of AV repair and root replacement in patients with BAV, AI and aortic dilatation | In-hospital mortality AV reoperation during follow-up Reoperation during follow-up | 0% 0% 6.3% |
| Schafers et al. (2007), Germany [39] | n = 173 Mean age 48 ± 16 years Male 80.3% | Retrospective cohort study comparing (A) root remodelling, (B) AV repair + supracommissural aortic replacement, (C) AV repair alone | In-hospital mortality TE Endocarditis | (A) 0% (B) 2.6% (C) 1.8% 0% (A) 0% (B) 0% (C) 1.3% |
| Schafers et al. (2010), Germany [40] | n = 153 Mean age 51 ± 12 years Male 86.9% Preoperative AI grade 2.6 ± 0.8 Aortic dissection 3.9% | Retrospective case series of valve-preserving root replacement for AI and BAV | In-hospital mortality 10-year overall survival 10-year freedom from AI > I 10-year freedom from reoperation 10-year freedom from AVR TE events Endocarditis 10-year freedom from AV complications | 0.7% 91% 90% 95% 97% 2.6% 0% 91% |
| Veldtman et al. (2006), USA [41] | n = 21 Mean age 45 ± 12 years Male 61.9% Marfan 9.5% AI > I 19.0% | Retrospective case series of aortic root repair or replacement with preservation of the BAV | Perioperative death Late death Reoperation | 0% 4.8% 9.5% |
| Author, year and country . | Demographicsa . | Study design . | Outcomesa . | Resultsa . |
|---|---|---|---|---|
| Aicher et al. (2004), Germany [15] | n = 60 Male 83.3% Mean age 53 ± 12 years Aortic dissection 6.7% | Retrospective cohort study comparing valve-sparing aortic root replacement in patients with TAV or BAV | In-hospital mortality Postoperative AI grade 5-year overall survival TE events/endocarditis during follow-up Reoperation during follow-up 5-year mean AV gradient 5-year freedom from AI > II 5-year freedom from reoperation | 0% 0.8 ± 0.7 82% 0% 1.7% 4.5 ± 2.3 mmHg 96% 98% |
| Aicher et al. (2007), Germany [16] | n = 81 Male 85.2% Aortic dissection 7.4% AI > II 55.6% Marfan 0% | Retrospective cohort study of aortic root remodelling in patients with BAV, AI and dilatation of the ascending aorta. Comparison made with patients with TAV | Hospital mortality 10-year overall survival 10-year freedom from AI > II 10-year freedom from reoperation 10-year freedom from AVR | 0% 94% 87% 97% 99% |
| Aicher et al. (2010), Germany [17] | n = 205 | Retrospective cohort study comparing AV repair in patients with BAV and TAV, limited raw data presented for BAV | 5-year freedom from AI > II 10-year freedom from AI > II | 86% 83% |
| Aicher et al. (2011), Germany [4] | n = 316 Male 84.8% Age range 3–79 years Aortic dissection 8% Severe AI 72.8% | Retrospective case series evaluating the effect of valve configuration on outcomes after repair of BAV | In-hospital mortality 10-year overall survival 10-year freedom from AI > II 10-year freedom from reoperation 10-year freedom from AVR | 0.63% 92% 81% 81% 84% |
| Alsoufi et al. (2005), Canada [18] | n = 71 Male 87.3% Mean age 41.5 ± 13.2 years | Retrospective case series of prospectively collected data on AV repair for AI secondary to BAV, aortic remodelling/ replacement included | Hospital mortality Postoperative AI > II 8-year overall survival Freedom from TE/haemorrhage 8-year freedom from reoperation 8-year freedom from endocarditis 8-year freedom from AI > II | 0% 0% 96.7% 100% 82.3% 90% 44.2% |
| Ashikhmina et al. (2010), USA [19] | n = 108 Male 91% Mean age 41 years | Retrospective case series of BAV repair. Patients with valve-sparing aortic root replacements were excluded | In-hospital mortality 10-year overall survival 10-year freedom from reoperation 10-year freedom from AVR | 0% 87% 64% 49% |
| Badiu et al. (2010), Germany [20] | n = 11 Male 100% Mean age 37 ± 15.8 years Aortic dissection 0% Marfan 0% | Retrospective cohort study comparing BAV and TAV repair for AI | Operative mortality 5-year overall survival 5-year freedom from reoperation 5-year freedom from AI 5-year freedom from TE events | 0% 100% 100% 57.1% 95.9% |
| Bakhtiary et al. (2009), Germany [21] | n = 14 Male 92.9% Mean age 58 ± 5 years AI > I 78.6% | Retrospective case series of patients undergoing the modified David procedure for incompetent BAV. | Endocarditis NE Operative death In-hospital death Late death | 0% 0% 0% 0% 0% |
| Boodhwani et al. (2009), Belgium [12] | n = 90 | Retrospective cohort study comparing aortic valve repair for AI in BAV and TAV, limited raw data presented for BAV | Comparison of freedom from AI recurrence between BAV and TAV | P = 0.7 |
| Boodhwani et al. (2010), Belgium [22] | n = 122 Male 92% Mean age 44 ± 11 years AI > II 86.1% | Retrospective case series of patients undergoing surgery for BAV in association with either AI or dilatation of the proximal aorta | In-hospital mortality Discharge AI < II 8-year overall survival 5-year freedom from AI > II 8-year freedom from AV reoperation 8-year freedom from AVR 8-year freedom from TE and bleeding | 0% 93% 97 ± 2% 94 ± 3% 83 ± 5% 90 ± 5% 96 ± 2% |
| Casselman et al. (1999), USA [23] | n = 94 Male 93% Mean age 38 ± 10 years | Retrospective case series of aortic valve repair in patients with BAV and AI | Immediate reoperation Immediate postoperative AI > II 7-year freedom from AV reoperation | 8.5% 2.1% 84% |
| Davierwala et al. (2003), Canada [24] | n = 44 Mean age 39.3 ± 12.1 years Male 93.2% Preoperative CCF 13.6% | Retrospective cohort study of prospectively collected data comparing AV repair to AVR in patients with AI caused by BAV. Procedures on the aorta were included | Operative mortality Late death TE/Haemorrhagic events 5-year freedom from AI > I 5-year freedom from AV reoperation | 0% 0% 0% 79 ± 8% 91 ± 5% |
| de Kerchove et al. (2009), Belgium [25] | n = 54 | Retrospective cohort study comparing the impact of preoperative AI on outcome after aortic valve-sparing surgery, limited raw data presented for BAV | 5-year freedom from AI > II 8-year freedom from AV reoperation | 98 ± 2% 91 ± 9% |
| Delius et al. (1998), USA [26] | n = 16 | Retrospective cohort study of aortic valve repair in patients with either subvalvular or supravalvular aortic stenosis. Comparison made between BAV and TAV | 10-year overall survival 5-year freedom from reoperation 5-year freedom from AVR | 100% 43% 43% |
| Doss et al. (2010), Germany [27] | n = 66 (A) n = 49; (B) n = 17 Mean age 41.2 ± 12 years (A) 58 years; (B) 39 yrs Male 78.8% (A) 82.3%; (B) 77.6% AI > II 95.4% (A) 82.3%; (B) 100% | Retrospective cohort study of (A) patch augmentation plus reduction aortoplasty vs (B) modified David procedure in patients with BAV and AI | 5-year mortality 5-year reoperation 5-year endocarditis 5-year conduction disturbance/thromboembolism/AI > I | (A) 2.0% (B) 0% (A) 2.0% (B) 0% (A) 2.0% (B) 0% (A) 0% (B) 0% |
| Fraser et al. (1994), USA [28] | n = 72 Male 94.4% Mean age 39 ± 11 years | Retrospective case series of AV repair for AI secondary to BAV | Operative death Late death 3-year freedom from AV reoperation | 0% 0% 89.5% |
| Kin et al. (2003), Japan [29] | n = 19 Male 98% Mean age 42 ± 17 years | Retrospective case series of AV repair for AI secondary to BAV, some patients underwent concomitant procedures on the aorta | Hospital death Early reoperation Reoperation at follow-up Late death 5-year overall survival 5-year freedom from AV reoperation | 5.2% 5.2% 15.8% 5.2% 90 ± 7% 76 ± 23% |
| Lausberg et al. (2006), Germany [30] | n = 89 n = 34; (B) n = 56 | Retrospective cohort study comparing (A) AV repair alone to (B) AV repair plus aortic root remodelling in patients with AI, limited data for BAV alone | Freedom from significant AI in (A) Freedom from reoperation in (A) | (A) 89.1% (A) 100% |
| Mangini et al. (2010), Italy [31] | n = 31 Mean age 49.9 ± 17.3 years Male 83.9% AI > I 96.8% | Prospective case series of patients undergoing repair of BAV for AI | 30-day operative mortality Discharge AI > I 5-year freedom from reoperation | 3.2% 3.2% 96.6% |
| McMullan et al. (2007), Australia [32] | n = 21 Median age 12.6 years Mean follow-up 36.4 months | Retrospective cohort study of tricuspidisation with cusp extension vs Ross procedure in children with AI or AS associated with BAV | Early reoperation Endocarditis during follow-up AVR during follow-up AI > 2 during follow-up | 9.5% 4.8% 9.5% 19.0% |
| Minakata et al. (2004), USA [14] | n = 54 | Retrospective case series of AV repair for AI, limited raw data presented for BAV | Reoperation during index admission Reoperation during follow-up 5-year reoperation rate | 3.7% 11.1% 9% |
| Moidl et al. (1995), Austria [33] | n = 14 Mean age 30.9 ± 12 years Male 92.9% Preoperative AI grade 3.5 ± 0.1 | Retrospective case series of valve-sparing correction of AI and BAV | Reoperation during index admission | 21.4% |
| Nash et al. (2004), USA [34] | n = 77 Mean age 38 ± 10 years Male 93% | Retrospective case series of the echocardiographic factors that predict successful AV repair in patients with BAV and AI | AVR during index admission Reoperation during index admission Perioperative death Thromboembolism Endocarditis | 2.6% 3.9% 0% 0% 0% |
| Odim et al. (2005), USA [35] | n = 39 | Retrospective case series of AV repair with pericardial leaflet extension | Early mortality 2-year freedom from reoperation | 2.6% 70–90% |
| Pretre et al. (2006), Switzerland [36] | n = 12 Median age 18 years Male 75% | Retrospective case series of AV repair with tricuspidization of the BAV | Postoperative morbidity AR > I | 0% 8.3% |
| Rao et al. (2000), Canada [37] | n = 23 | Retrospective case series of AV repair for multiple pathologies, limited raw data presented for BAV | Composite endpoint of reoperation or AI | No difference between BAV and TAV (P > 0.05) |
| Schafers et al. (2000), Germany [38] | n = 16 Age range 35–73 years Male 75% Aortic dissection 6.3% | Retrospective case series of AV repair and root replacement in patients with BAV, AI and aortic dilatation | In-hospital mortality AV reoperation during follow-up Reoperation during follow-up | 0% 0% 6.3% |
| Schafers et al. (2007), Germany [39] | n = 173 Mean age 48 ± 16 years Male 80.3% | Retrospective cohort study comparing (A) root remodelling, (B) AV repair + supracommissural aortic replacement, (C) AV repair alone | In-hospital mortality TE Endocarditis | (A) 0% (B) 2.6% (C) 1.8% 0% (A) 0% (B) 0% (C) 1.3% |
| Schafers et al. (2010), Germany [40] | n = 153 Mean age 51 ± 12 years Male 86.9% Preoperative AI grade 2.6 ± 0.8 Aortic dissection 3.9% | Retrospective case series of valve-preserving root replacement for AI and BAV | In-hospital mortality 10-year overall survival 10-year freedom from AI > I 10-year freedom from reoperation 10-year freedom from AVR TE events Endocarditis 10-year freedom from AV complications | 0.7% 91% 90% 95% 97% 2.6% 0% 91% |
| Veldtman et al. (2006), USA [41] | n = 21 Mean age 45 ± 12 years Male 61.9% Marfan 9.5% AI > I 19.0% | Retrospective case series of aortic root repair or replacement with preservation of the BAV | Perioperative death Late death Reoperation | 0% 4.8% 9.5% |
aWhere studies have included both patients with BAV and TAV repair, only demographics, outcomes and results of patients with BAV are reported.
AI: aortic insufficiency; AS: aortic stenosis; AV: aortic valve; AVR: aortic valve replacement; BAV: bicuspid aortic valve; CCF: congestive cardiac failure; TAV: tricuspid aortic valve; TE: thromboembolism.
| Author, year and country . | Demographicsa . | Study design . | Outcomesa . | Resultsa . |
|---|---|---|---|---|
| Aicher et al. (2004), Germany [15] | n = 60 Male 83.3% Mean age 53 ± 12 years Aortic dissection 6.7% | Retrospective cohort study comparing valve-sparing aortic root replacement in patients with TAV or BAV | In-hospital mortality Postoperative AI grade 5-year overall survival TE events/endocarditis during follow-up Reoperation during follow-up 5-year mean AV gradient 5-year freedom from AI > II 5-year freedom from reoperation | 0% 0.8 ± 0.7 82% 0% 1.7% 4.5 ± 2.3 mmHg 96% 98% |
| Aicher et al. (2007), Germany [16] | n = 81 Male 85.2% Aortic dissection 7.4% AI > II 55.6% Marfan 0% | Retrospective cohort study of aortic root remodelling in patients with BAV, AI and dilatation of the ascending aorta. Comparison made with patients with TAV | Hospital mortality 10-year overall survival 10-year freedom from AI > II 10-year freedom from reoperation 10-year freedom from AVR | 0% 94% 87% 97% 99% |
| Aicher et al. (2010), Germany [17] | n = 205 | Retrospective cohort study comparing AV repair in patients with BAV and TAV, limited raw data presented for BAV | 5-year freedom from AI > II 10-year freedom from AI > II | 86% 83% |
| Aicher et al. (2011), Germany [4] | n = 316 Male 84.8% Age range 3–79 years Aortic dissection 8% Severe AI 72.8% | Retrospective case series evaluating the effect of valve configuration on outcomes after repair of BAV | In-hospital mortality 10-year overall survival 10-year freedom from AI > II 10-year freedom from reoperation 10-year freedom from AVR | 0.63% 92% 81% 81% 84% |
| Alsoufi et al. (2005), Canada [18] | n = 71 Male 87.3% Mean age 41.5 ± 13.2 years | Retrospective case series of prospectively collected data on AV repair for AI secondary to BAV, aortic remodelling/ replacement included | Hospital mortality Postoperative AI > II 8-year overall survival Freedom from TE/haemorrhage 8-year freedom from reoperation 8-year freedom from endocarditis 8-year freedom from AI > II | 0% 0% 96.7% 100% 82.3% 90% 44.2% |
| Ashikhmina et al. (2010), USA [19] | n = 108 Male 91% Mean age 41 years | Retrospective case series of BAV repair. Patients with valve-sparing aortic root replacements were excluded | In-hospital mortality 10-year overall survival 10-year freedom from reoperation 10-year freedom from AVR | 0% 87% 64% 49% |
| Badiu et al. (2010), Germany [20] | n = 11 Male 100% Mean age 37 ± 15.8 years Aortic dissection 0% Marfan 0% | Retrospective cohort study comparing BAV and TAV repair for AI | Operative mortality 5-year overall survival 5-year freedom from reoperation 5-year freedom from AI 5-year freedom from TE events | 0% 100% 100% 57.1% 95.9% |
| Bakhtiary et al. (2009), Germany [21] | n = 14 Male 92.9% Mean age 58 ± 5 years AI > I 78.6% | Retrospective case series of patients undergoing the modified David procedure for incompetent BAV. | Endocarditis NE Operative death In-hospital death Late death | 0% 0% 0% 0% 0% |
| Boodhwani et al. (2009), Belgium [12] | n = 90 | Retrospective cohort study comparing aortic valve repair for AI in BAV and TAV, limited raw data presented for BAV | Comparison of freedom from AI recurrence between BAV and TAV | P = 0.7 |
| Boodhwani et al. (2010), Belgium [22] | n = 122 Male 92% Mean age 44 ± 11 years AI > II 86.1% | Retrospective case series of patients undergoing surgery for BAV in association with either AI or dilatation of the proximal aorta | In-hospital mortality Discharge AI < II 8-year overall survival 5-year freedom from AI > II 8-year freedom from AV reoperation 8-year freedom from AVR 8-year freedom from TE and bleeding | 0% 93% 97 ± 2% 94 ± 3% 83 ± 5% 90 ± 5% 96 ± 2% |
| Casselman et al. (1999), USA [23] | n = 94 Male 93% Mean age 38 ± 10 years | Retrospective case series of aortic valve repair in patients with BAV and AI | Immediate reoperation Immediate postoperative AI > II 7-year freedom from AV reoperation | 8.5% 2.1% 84% |
| Davierwala et al. (2003), Canada [24] | n = 44 Mean age 39.3 ± 12.1 years Male 93.2% Preoperative CCF 13.6% | Retrospective cohort study of prospectively collected data comparing AV repair to AVR in patients with AI caused by BAV. Procedures on the aorta were included | Operative mortality Late death TE/Haemorrhagic events 5-year freedom from AI > I 5-year freedom from AV reoperation | 0% 0% 0% 79 ± 8% 91 ± 5% |
| de Kerchove et al. (2009), Belgium [25] | n = 54 | Retrospective cohort study comparing the impact of preoperative AI on outcome after aortic valve-sparing surgery, limited raw data presented for BAV | 5-year freedom from AI > II 8-year freedom from AV reoperation | 98 ± 2% 91 ± 9% |
| Delius et al. (1998), USA [26] | n = 16 | Retrospective cohort study of aortic valve repair in patients with either subvalvular or supravalvular aortic stenosis. Comparison made between BAV and TAV | 10-year overall survival 5-year freedom from reoperation 5-year freedom from AVR | 100% 43% 43% |
| Doss et al. (2010), Germany [27] | n = 66 (A) n = 49; (B) n = 17 Mean age 41.2 ± 12 years (A) 58 years; (B) 39 yrs Male 78.8% (A) 82.3%; (B) 77.6% AI > II 95.4% (A) 82.3%; (B) 100% | Retrospective cohort study of (A) patch augmentation plus reduction aortoplasty vs (B) modified David procedure in patients with BAV and AI | 5-year mortality 5-year reoperation 5-year endocarditis 5-year conduction disturbance/thromboembolism/AI > I | (A) 2.0% (B) 0% (A) 2.0% (B) 0% (A) 2.0% (B) 0% (A) 0% (B) 0% |
| Fraser et al. (1994), USA [28] | n = 72 Male 94.4% Mean age 39 ± 11 years | Retrospective case series of AV repair for AI secondary to BAV | Operative death Late death 3-year freedom from AV reoperation | 0% 0% 89.5% |
| Kin et al. (2003), Japan [29] | n = 19 Male 98% Mean age 42 ± 17 years | Retrospective case series of AV repair for AI secondary to BAV, some patients underwent concomitant procedures on the aorta | Hospital death Early reoperation Reoperation at follow-up Late death 5-year overall survival 5-year freedom from AV reoperation | 5.2% 5.2% 15.8% 5.2% 90 ± 7% 76 ± 23% |
| Lausberg et al. (2006), Germany [30] | n = 89 n = 34; (B) n = 56 | Retrospective cohort study comparing (A) AV repair alone to (B) AV repair plus aortic root remodelling in patients with AI, limited data for BAV alone | Freedom from significant AI in (A) Freedom from reoperation in (A) | (A) 89.1% (A) 100% |
| Mangini et al. (2010), Italy [31] | n = 31 Mean age 49.9 ± 17.3 years Male 83.9% AI > I 96.8% | Prospective case series of patients undergoing repair of BAV for AI | 30-day operative mortality Discharge AI > I 5-year freedom from reoperation | 3.2% 3.2% 96.6% |
| McMullan et al. (2007), Australia [32] | n = 21 Median age 12.6 years Mean follow-up 36.4 months | Retrospective cohort study of tricuspidisation with cusp extension vs Ross procedure in children with AI or AS associated with BAV | Early reoperation Endocarditis during follow-up AVR during follow-up AI > 2 during follow-up | 9.5% 4.8% 9.5% 19.0% |
| Minakata et al. (2004), USA [14] | n = 54 | Retrospective case series of AV repair for AI, limited raw data presented for BAV | Reoperation during index admission Reoperation during follow-up 5-year reoperation rate | 3.7% 11.1% 9% |
| Moidl et al. (1995), Austria [33] | n = 14 Mean age 30.9 ± 12 years Male 92.9% Preoperative AI grade 3.5 ± 0.1 | Retrospective case series of valve-sparing correction of AI and BAV | Reoperation during index admission | 21.4% |
| Nash et al. (2004), USA [34] | n = 77 Mean age 38 ± 10 years Male 93% | Retrospective case series of the echocardiographic factors that predict successful AV repair in patients with BAV and AI | AVR during index admission Reoperation during index admission Perioperative death Thromboembolism Endocarditis | 2.6% 3.9% 0% 0% 0% |
| Odim et al. (2005), USA [35] | n = 39 | Retrospective case series of AV repair with pericardial leaflet extension | Early mortality 2-year freedom from reoperation | 2.6% 70–90% |
| Pretre et al. (2006), Switzerland [36] | n = 12 Median age 18 years Male 75% | Retrospective case series of AV repair with tricuspidization of the BAV | Postoperative morbidity AR > I | 0% 8.3% |
| Rao et al. (2000), Canada [37] | n = 23 | Retrospective case series of AV repair for multiple pathologies, limited raw data presented for BAV | Composite endpoint of reoperation or AI | No difference between BAV and TAV (P > 0.05) |
| Schafers et al. (2000), Germany [38] | n = 16 Age range 35–73 years Male 75% Aortic dissection 6.3% | Retrospective case series of AV repair and root replacement in patients with BAV, AI and aortic dilatation | In-hospital mortality AV reoperation during follow-up Reoperation during follow-up | 0% 0% 6.3% |
| Schafers et al. (2007), Germany [39] | n = 173 Mean age 48 ± 16 years Male 80.3% | Retrospective cohort study comparing (A) root remodelling, (B) AV repair + supracommissural aortic replacement, (C) AV repair alone | In-hospital mortality TE Endocarditis | (A) 0% (B) 2.6% (C) 1.8% 0% (A) 0% (B) 0% (C) 1.3% |
| Schafers et al. (2010), Germany [40] | n = 153 Mean age 51 ± 12 years Male 86.9% Preoperative AI grade 2.6 ± 0.8 Aortic dissection 3.9% | Retrospective case series of valve-preserving root replacement for AI and BAV | In-hospital mortality 10-year overall survival 10-year freedom from AI > I 10-year freedom from reoperation 10-year freedom from AVR TE events Endocarditis 10-year freedom from AV complications | 0.7% 91% 90% 95% 97% 2.6% 0% 91% |
| Veldtman et al. (2006), USA [41] | n = 21 Mean age 45 ± 12 years Male 61.9% Marfan 9.5% AI > I 19.0% | Retrospective case series of aortic root repair or replacement with preservation of the BAV | Perioperative death Late death Reoperation | 0% 4.8% 9.5% |
| Author, year and country . | Demographicsa . | Study design . | Outcomesa . | Resultsa . |
|---|---|---|---|---|
| Aicher et al. (2004), Germany [15] | n = 60 Male 83.3% Mean age 53 ± 12 years Aortic dissection 6.7% | Retrospective cohort study comparing valve-sparing aortic root replacement in patients with TAV or BAV | In-hospital mortality Postoperative AI grade 5-year overall survival TE events/endocarditis during follow-up Reoperation during follow-up 5-year mean AV gradient 5-year freedom from AI > II 5-year freedom from reoperation | 0% 0.8 ± 0.7 82% 0% 1.7% 4.5 ± 2.3 mmHg 96% 98% |
| Aicher et al. (2007), Germany [16] | n = 81 Male 85.2% Aortic dissection 7.4% AI > II 55.6% Marfan 0% | Retrospective cohort study of aortic root remodelling in patients with BAV, AI and dilatation of the ascending aorta. Comparison made with patients with TAV | Hospital mortality 10-year overall survival 10-year freedom from AI > II 10-year freedom from reoperation 10-year freedom from AVR | 0% 94% 87% 97% 99% |
| Aicher et al. (2010), Germany [17] | n = 205 | Retrospective cohort study comparing AV repair in patients with BAV and TAV, limited raw data presented for BAV | 5-year freedom from AI > II 10-year freedom from AI > II | 86% 83% |
| Aicher et al. (2011), Germany [4] | n = 316 Male 84.8% Age range 3–79 years Aortic dissection 8% Severe AI 72.8% | Retrospective case series evaluating the effect of valve configuration on outcomes after repair of BAV | In-hospital mortality 10-year overall survival 10-year freedom from AI > II 10-year freedom from reoperation 10-year freedom from AVR | 0.63% 92% 81% 81% 84% |
| Alsoufi et al. (2005), Canada [18] | n = 71 Male 87.3% Mean age 41.5 ± 13.2 years | Retrospective case series of prospectively collected data on AV repair for AI secondary to BAV, aortic remodelling/ replacement included | Hospital mortality Postoperative AI > II 8-year overall survival Freedom from TE/haemorrhage 8-year freedom from reoperation 8-year freedom from endocarditis 8-year freedom from AI > II | 0% 0% 96.7% 100% 82.3% 90% 44.2% |
| Ashikhmina et al. (2010), USA [19] | n = 108 Male 91% Mean age 41 years | Retrospective case series of BAV repair. Patients with valve-sparing aortic root replacements were excluded | In-hospital mortality 10-year overall survival 10-year freedom from reoperation 10-year freedom from AVR | 0% 87% 64% 49% |
| Badiu et al. (2010), Germany [20] | n = 11 Male 100% Mean age 37 ± 15.8 years Aortic dissection 0% Marfan 0% | Retrospective cohort study comparing BAV and TAV repair for AI | Operative mortality 5-year overall survival 5-year freedom from reoperation 5-year freedom from AI 5-year freedom from TE events | 0% 100% 100% 57.1% 95.9% |
| Bakhtiary et al. (2009), Germany [21] | n = 14 Male 92.9% Mean age 58 ± 5 years AI > I 78.6% | Retrospective case series of patients undergoing the modified David procedure for incompetent BAV. | Endocarditis NE Operative death In-hospital death Late death | 0% 0% 0% 0% 0% |
| Boodhwani et al. (2009), Belgium [12] | n = 90 | Retrospective cohort study comparing aortic valve repair for AI in BAV and TAV, limited raw data presented for BAV | Comparison of freedom from AI recurrence between BAV and TAV | P = 0.7 |
| Boodhwani et al. (2010), Belgium [22] | n = 122 Male 92% Mean age 44 ± 11 years AI > II 86.1% | Retrospective case series of patients undergoing surgery for BAV in association with either AI or dilatation of the proximal aorta | In-hospital mortality Discharge AI < II 8-year overall survival 5-year freedom from AI > II 8-year freedom from AV reoperation 8-year freedom from AVR 8-year freedom from TE and bleeding | 0% 93% 97 ± 2% 94 ± 3% 83 ± 5% 90 ± 5% 96 ± 2% |
| Casselman et al. (1999), USA [23] | n = 94 Male 93% Mean age 38 ± 10 years | Retrospective case series of aortic valve repair in patients with BAV and AI | Immediate reoperation Immediate postoperative AI > II 7-year freedom from AV reoperation | 8.5% 2.1% 84% |
| Davierwala et al. (2003), Canada [24] | n = 44 Mean age 39.3 ± 12.1 years Male 93.2% Preoperative CCF 13.6% | Retrospective cohort study of prospectively collected data comparing AV repair to AVR in patients with AI caused by BAV. Procedures on the aorta were included | Operative mortality Late death TE/Haemorrhagic events 5-year freedom from AI > I 5-year freedom from AV reoperation | 0% 0% 0% 79 ± 8% 91 ± 5% |
| de Kerchove et al. (2009), Belgium [25] | n = 54 | Retrospective cohort study comparing the impact of preoperative AI on outcome after aortic valve-sparing surgery, limited raw data presented for BAV | 5-year freedom from AI > II 8-year freedom from AV reoperation | 98 ± 2% 91 ± 9% |
| Delius et al. (1998), USA [26] | n = 16 | Retrospective cohort study of aortic valve repair in patients with either subvalvular or supravalvular aortic stenosis. Comparison made between BAV and TAV | 10-year overall survival 5-year freedom from reoperation 5-year freedom from AVR | 100% 43% 43% |
| Doss et al. (2010), Germany [27] | n = 66 (A) n = 49; (B) n = 17 Mean age 41.2 ± 12 years (A) 58 years; (B) 39 yrs Male 78.8% (A) 82.3%; (B) 77.6% AI > II 95.4% (A) 82.3%; (B) 100% | Retrospective cohort study of (A) patch augmentation plus reduction aortoplasty vs (B) modified David procedure in patients with BAV and AI | 5-year mortality 5-year reoperation 5-year endocarditis 5-year conduction disturbance/thromboembolism/AI > I | (A) 2.0% (B) 0% (A) 2.0% (B) 0% (A) 2.0% (B) 0% (A) 0% (B) 0% |
| Fraser et al. (1994), USA [28] | n = 72 Male 94.4% Mean age 39 ± 11 years | Retrospective case series of AV repair for AI secondary to BAV | Operative death Late death 3-year freedom from AV reoperation | 0% 0% 89.5% |
| Kin et al. (2003), Japan [29] | n = 19 Male 98% Mean age 42 ± 17 years | Retrospective case series of AV repair for AI secondary to BAV, some patients underwent concomitant procedures on the aorta | Hospital death Early reoperation Reoperation at follow-up Late death 5-year overall survival 5-year freedom from AV reoperation | 5.2% 5.2% 15.8% 5.2% 90 ± 7% 76 ± 23% |
| Lausberg et al. (2006), Germany [30] | n = 89 n = 34; (B) n = 56 | Retrospective cohort study comparing (A) AV repair alone to (B) AV repair plus aortic root remodelling in patients with AI, limited data for BAV alone | Freedom from significant AI in (A) Freedom from reoperation in (A) | (A) 89.1% (A) 100% |
| Mangini et al. (2010), Italy [31] | n = 31 Mean age 49.9 ± 17.3 years Male 83.9% AI > I 96.8% | Prospective case series of patients undergoing repair of BAV for AI | 30-day operative mortality Discharge AI > I 5-year freedom from reoperation | 3.2% 3.2% 96.6% |
| McMullan et al. (2007), Australia [32] | n = 21 Median age 12.6 years Mean follow-up 36.4 months | Retrospective cohort study of tricuspidisation with cusp extension vs Ross procedure in children with AI or AS associated with BAV | Early reoperation Endocarditis during follow-up AVR during follow-up AI > 2 during follow-up | 9.5% 4.8% 9.5% 19.0% |
| Minakata et al. (2004), USA [14] | n = 54 | Retrospective case series of AV repair for AI, limited raw data presented for BAV | Reoperation during index admission Reoperation during follow-up 5-year reoperation rate | 3.7% 11.1% 9% |
| Moidl et al. (1995), Austria [33] | n = 14 Mean age 30.9 ± 12 years Male 92.9% Preoperative AI grade 3.5 ± 0.1 | Retrospective case series of valve-sparing correction of AI and BAV | Reoperation during index admission | 21.4% |
| Nash et al. (2004), USA [34] | n = 77 Mean age 38 ± 10 years Male 93% | Retrospective case series of the echocardiographic factors that predict successful AV repair in patients with BAV and AI | AVR during index admission Reoperation during index admission Perioperative death Thromboembolism Endocarditis | 2.6% 3.9% 0% 0% 0% |
| Odim et al. (2005), USA [35] | n = 39 | Retrospective case series of AV repair with pericardial leaflet extension | Early mortality 2-year freedom from reoperation | 2.6% 70–90% |
| Pretre et al. (2006), Switzerland [36] | n = 12 Median age 18 years Male 75% | Retrospective case series of AV repair with tricuspidization of the BAV | Postoperative morbidity AR > I | 0% 8.3% |
| Rao et al. (2000), Canada [37] | n = 23 | Retrospective case series of AV repair for multiple pathologies, limited raw data presented for BAV | Composite endpoint of reoperation or AI | No difference between BAV and TAV (P > 0.05) |
| Schafers et al. (2000), Germany [38] | n = 16 Age range 35–73 years Male 75% Aortic dissection 6.3% | Retrospective case series of AV repair and root replacement in patients with BAV, AI and aortic dilatation | In-hospital mortality AV reoperation during follow-up Reoperation during follow-up | 0% 0% 6.3% |
| Schafers et al. (2007), Germany [39] | n = 173 Mean age 48 ± 16 years Male 80.3% | Retrospective cohort study comparing (A) root remodelling, (B) AV repair + supracommissural aortic replacement, (C) AV repair alone | In-hospital mortality TE Endocarditis | (A) 0% (B) 2.6% (C) 1.8% 0% (A) 0% (B) 0% (C) 1.3% |
| Schafers et al. (2010), Germany [40] | n = 153 Mean age 51 ± 12 years Male 86.9% Preoperative AI grade 2.6 ± 0.8 Aortic dissection 3.9% | Retrospective case series of valve-preserving root replacement for AI and BAV | In-hospital mortality 10-year overall survival 10-year freedom from AI > I 10-year freedom from reoperation 10-year freedom from AVR TE events Endocarditis 10-year freedom from AV complications | 0.7% 91% 90% 95% 97% 2.6% 0% 91% |
| Veldtman et al. (2006), USA [41] | n = 21 Mean age 45 ± 12 years Male 61.9% Marfan 9.5% AI > I 19.0% | Retrospective case series of aortic root repair or replacement with preservation of the BAV | Perioperative death Late death Reoperation | 0% 4.8% 9.5% |
aWhere studies have included both patients with BAV and TAV repair, only demographics, outcomes and results of patients with BAV are reported.
AI: aortic insufficiency; AS: aortic stenosis; AV: aortic valve; AVR: aortic valve replacement; BAV: bicuspid aortic valve; CCF: congestive cardiac failure; TAV: tricuspid aortic valve; TE: thromboembolism.
This PDF is available to Subscribers Only
View Article Abstract & Purchase OptionsFor full access to this pdf, sign in to an existing account, or purchase an annual subscription.
