Comparative analysis of changes in the sizes of Valsalva sinuses at medium-term follow-up after prosthetics of the ascending aorta and bicuspid/tricuspid aortic valve

Introduction. The issue of adequate surgical tactics in relation to the volume of aortic wall resection in aortic valve stenosis in combination with an ascending aortic aneurysm is recognized as relevant and debatable.

Aim: To compare the mid-term results of surgical reconstruction of the ascending aorta and prosthetics of the aortic valve for stenosis in patients with its bicuspid and tricuspid anatomy.

Material and Methods. A retrospective analysis of the results of surgical treatment of 102 patients with ascending aortic aneurysm and aortic valve stenotic defect was performed. All patients were divided into 2 groups depending on the anatomy of the aortic valve: bicuspid (AAA + BAV, n = 75) or tricuspid (AAA + TAV, n = 27). The data analysis included an intergroup comparison of postoperative results in the near and midi-term postoperative periods.

Results. Mid-term survival of AAA + BAV and AAA + TAV patients it reached 97.4% and 100%, respectively. There were no episodes of repeated surgical intervention on the thoracic aorta. In AAA + BAV patients, a moderate increase in Valsalva sinuses was noted, and in AAA + TAV patients, a decrease in the size of the aortic root was noted in the postoperative period. Conclusion. Combined surgeriess for ascending aortic aneurysm and stenotic aortic valve are associated with satisfactory early and mid-term results, including high level of survival and freedom from surgery for up to 36 months, regardless of the anatomy of the aortic valve.

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