{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T22:32:01Z","timestamp":1793226721666,"version":"4.5.0"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2024,3,29]],"date-time":"2024-03-29T00:00:00Z","timestamp":1711670400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,3,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p\/>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>Repair of the bicuspid aortic valve (BAV) has evolved in the past 25\u2009years. The aim of this study was to review and analyse the long-term durability of isolated BAV repair with particular focus on commissural orientation (CO).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>All patients who underwent BAV repair for severe aortic regurgitation between October 1998 and December 2022 were included. The study group consists of all patients operated after 2009, i.e. since CO modification. The control group includes patients who were operated before 2009. CO was classified as symmetric, asymmetric and very asymmetric.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Overall, 594 adult patients (93% male; mean age 42\u2009years) were included. At 15\u2009years, survival was 94.8% [standard deviation (SD): 2.2]; freedom from reoperation was 86.8% (SD: 2.3). Freedom from aortic insufficiency \u2265II was 70.8% (SD: 4.7) at 15\u2009years. Modification of CO by sinus plication was performed in 200 (33.7%) instances. Using competing risks analysis, the absence of effective height measurement (P\u2009=\u20090.018), very asymmetric CO (P\u2009=\u20090.028), the presence of calcification (P\u2009&amp;lt;\u20090.001), the use of pericardial patch (P\u2009&amp;lt;\u20090.001), the use of subcommissural sutures (P\u2009&amp;lt;\u20090.001) and preoperative endocarditis (P\u2009=\u20090.005) were identified as independent predictors for reoperation. Follow-up was 97% complete (4228 patient-years); mean follow-up was 7\u2009years (SD: 5).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Isolated BAV repair leads to good survival and durability in all morphologic types if cusp repair is guided by effective height, suture annuloplasty is performed, and CO is modified using sinus plication in asymmetrical valves. Very asymmetrical valves may should be treated with a lower threshold for replacement.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezae163","type":"journal-article","created":{"date-parts":[[2024,4,12]],"date-time":"2024-04-12T19:30:02Z","timestamp":1712950202000},"source":"Crossref","is-referenced-by-count":21,"title":["Twenty-five years\u2019 experience with isolated bicuspid aortic valve repair: impact of commissural orientation"],"prefix":"10.1093","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6217-5963","authenticated-orcid":false,"given":"Tristan","family":"Ehrlich","sequence":"first","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Saarland University Medical Center , Homburg, Germany"},{"name":"Department of Cardiovascular Surgery and Heart Transplantation, University Hospital of Nancy-Brabois , Vandoeuvre-l\u00e8s-Nancy, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6110-3124","authenticated-orcid":false,"given":"Karen B","family":"Abeln","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Saarland University Medical Center , Homburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lennart","family":"Froede","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Saarland University Medical Center , Homburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flora","family":"Schmitt","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Saarland University Medical Center , Homburg, 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