Long Term Outcome of Childhood Bicuspid Aortic Valve

The most common congenital heart defect is a bicuspid aortic valve (BAV), which is often genetic and the cause is unknown. The defect occurs in only 1% of the general population. A BAV is not able to fully stop blood from leaking back into the heart, which is known as aortic regurgitation. Another common issue with a BAV is that it may be too stiff to fully open, which is known as aortic stenosis. In early childhood, children with aortic stenosis often need palliation with a balloon or surgical valvotomy. As these children develop, they may need subsequent, more definitive procedures such as a Ross procedure, insertion of a tissue valve or mechanical valve, or a valve repair. These definitive operations are used to address recurrent aortic stenosis or regurgitation. As a result, comparing the long-term complications of valve interventions in infancy was an area of considerable interest. The goal of this study was to compare whether one procedure is more effective in providing a more functional status in adulthood since comparative data on the morbidity and mortality associated with each definitive repair in a contemporaneous cohort is lacking. Clinical evidence suggests that repeat surgical procedures are very common in all surgical interventions for bicuspid aortic valve with aortic stenosis in childhood. Incidences of a greater number of aortic valve surgery is associated with a higher incidence of surgical complications and endocarditis. Long-term follow up on the odds of a composite adverse outcome are less with a Ross procedure.https://digitalcommons.unmc.edu/surp2021/1011/thumbnail.jp