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Management of Bicuspid Aortic Valve Aortopathy: To Perform or Not to Perform Circulatory Arrest
By Amy Qiang, Shelby Coons, Morgan Whisenhunt and 6 others.
Abstract
Purpose
Equipoise persists regarding the extent of surgical resection in bicuspid aortic valve aortopathy. We desired to determine if initial postoperative ventilator hours or hospital length of stay differed between open hemiarch and clamped distal anastomosis cohorts.
Methods
Patients with a bicuspid aortic valve undergoing elective or urgent first-time ascending aortic replacement at a single institution from July 2020 to December 2024 were retrospectively reviewed from a prospectively maintained database. Primary outcomes of interest were survival to hospital discharge, duration of postoperative ventilation, and hospital length of stay. We additionally compared rates of postoperative transfusion, stroke, and unplanned reoperation. Patients with bicuspid aortopathy were divided into two cohorts: open anastomosis under circulatory arrest versus clamped distal anastomosis and matched 1:3 based on a 10 covariate propensity score.