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

二叶式主动脉瓣合并严重主动脉缩窄:单阶段手术还是分阶段手术?

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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.

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