Key result
A 44-year-old male with a bicuspid aortic valve, severe aortic insufficiency, and a 34 mm annulus presented for valve repair using an external subannular ring.
Why the study?
Annuloplasty is a key component of bicuspid aortic valve repair for severe aortic insufficiency to enhance leaflet coaptation and prevent recurrent AI, with external subannular rings used when the annulus measures >27 mm.
Case Report (n=1)
No
Case report describing the use of an external subannular ring for bicuspid aortic valve repair in a patient with severe aortic insufficiency and an enlarged annulus.
Annuloplasty is a key component of bicuspid aortic valve (BAV) repair for severe aortic insufficiency (AI). Reduction of the annular diameter enhances leaflet coaptation, while annular stabilization prevents subsequent dilation, which can lead to recurrent AI and repair failure. Several techniques have been described, including valve-sparing root reimplantation (VSRR), subcommissural annuloplasty (SCA), suture annuloplasty, and external subannular ring (ESAR). At our institution, BAV repair with VSRR is performed in patients with severe AI and an aortic root aneurysm (>4.5 cm). For those presenting with a BAV and severe AI without root enlargement, concomitant SCA is performed when the preoperative annulus is 27 mm, while ESAR is employed when the annulus measures >27 mm. A 44-year-old male with known BAV presented to our institution with severe AI and in New York Heart Association (NYHA) Class III heart failure. Pre-procedure transesophageal echocardiogram revealed an annular measurement of 34 mm.
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Kelly et al. (2021) conducted a case report in Bicuspid aortic valve with severe aortic insufficiency (n=1). Bicuspid aortic valve repair with external subannular ring was evaluated. A 44-year-old male with a bicuspid aortic valve, severe aortic insufficiency, and a 34 mm annulus presented for valve repair using an external subannular ring.
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