Congenital bicuspid aortic valve and an aneurysm of the ascending aorta

BACKGROUND: A congenital bicuspid aortic valve (BAV) in adults is known to be associated with aortopathy, specifically with aneurysms of the ascending aorta (AA). MATERIALS AND METHODS: Ten (16.7%) patients with congenital BAV had an aneurysm of the AA. Aortic valve replacement was performed in 58 patients, repair in two. Aneurysms were repaired by a vertical reduction (tailoring) aortoplasty (VRA) with or without external synthetic grafting (wrapping, wrap) in nine patients, replaced in one. RESULTS: There were no operative deaths. One patient died 87 months after the operation due to a noncardiac cause. Fifty-four patients are alive and well, without the evidence of recurrence of an aneurysm. CONCLUSIONS: A VRA with or without external synthetic wrapping appears to be a satisfactory alternative to replacement procedures for the AA aneurysm in older patients with BAV, and those with comorbid conditions.