Bicuspid aortic valve with critical coarctation of the aorta: single- or two-stage operation?

Hongqiang Zhang; Kai Zhu; Shouguo Yang; Junyu Zhai; Tianyu Zhou; Xiaoning Sun; Chunsheng Wang

doi:10.21037/jtd.2018.06.112

Bicuspid aortic valve with critical coarctation of the aorta: single- or two-stage operation?

J Thorac Dis. 2018 Jul;10(7):4353-4359. doi: 10.21037/jtd.2018.06.112.

Authors

Hongqiang Zhang^{1

2}, Kai Zhu^{1

2}, Shouguo Yang^{1

2}, Junyu Zhai^{1

2}, Tianyu Zhou^{1

2}, Xiaoning Sun^{1

2}, Chunsheng Wang^{1

2}

Affiliations

¹ Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
² Shanghai Institute of Cardiovascular Disease, Shanghai 200032, China.

Abstract

Background: A bicuspid aortic valve (BAV) with critical coarctation of the aorta (CoA) is a rare but dangerous congenital cardiac malformation. The aim of this study was to compare the benefits of a single- versus two-stage operation for patients of BAV with CoA.

Methods: We retrospectively evaluated 20 patients of BAV and CoA who underwent surgery from 2000 to 2016 in our center. Eight patients underwent a single-stage procedure through a median sternotomy approach, while 12 patients underwent two-stage operation.

Results: The patients' baseline characteristics were similar between the two groups, and the overall mortality rate was 0%. No significant differences were found in the postoperative pressure gradient (P=0.64), use of implants (P=0.81), reoperation for bleeding, phrenic nerve injury, blood transfusion (P=1.00), or thromboembolic events between the two groups. However, patients in the single-stage group sustained less surgical trauma and ICU stay hours (P<0.01) than those in the two-stage group.

Conclusions: Performance of a single-stage operation was feasible for patients of BAV with CoA. It was a safe and optimal choice with less surgical trauma compared with a two-stage operation.

Keywords: Bicuspid aortic valve (BAV); coarctation of the aorta (CoA); surgical treatment.