Aortic Regurgitation

Aortic Root Replacement Indications

Many patients with bicuspid aortic valves have disorders of vascular connective tissue including cystic medial degeneration, that may result in dilation of the aortic root and ascending aorta, even in the absence of hemodynamically significant aortic stenosis or aortic regurgitation. Therefore, careful evaluation of the aortic root and ascending aorta diameter is important in such patients.

In patients with normally functioning bicuspid valves, aortic root and/or ascending aorta replacement should be considered if either or both aortic diameters are greater than five centimeters.

In patients with stenotic or regurgitant bicuspid valves that need replacement, aortic root and/or ascending aorta replacement should be considered if either aortic diameter is greater than 4.5 centimeters. In such patients, the aortic root replacement can be with a conduit containing a prosthetic aortic valve, usually a bioprosthesis, the so-called Bentall procedure.

Our Patient Postoperatively

He did well postoperatively with no recurrence of his symptoms. He was treated with an anticoagulant. He was also advised to take antibiotics for infective endocarditis prophylaxis at the time of certain surgeries and procedures including cleaning of his teeth.