{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T08:51:01Z","timestamp":1793436661510,"version":"4.5.0"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2011,1,18]]},"abstract":"<jats:sec>\n                    <jats:title>Background\u2014<\/jats:title>\n                    <jats:p>Reconstruction of the regurgitant bicuspid aortic valve has been performed for &gt;10 years, but there is limited information on long-term results. We analyzed our results to determine the predictors of suboptimal outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results\u2014<\/jats:title>\n                    <jats:p>Between November 1995 and December 2008, 316 patients (age, 49\u00b114 years; male, 268) underwent reconstruction of a regurgitant bicuspid aortic valve. Intraoperative assessment included extent of fusion, root dimensions, circumferential orientation of the 2 normal commissures (&gt;160\u00b0, \u2264160\u00b0), and effective height after repair. Cusp pathology was treated by central plication (n=277), triangular resection (n=138), or pericardial patch (n=94). Root dilatation was treated by subcommissural plication (n=100), root remodeling (n=122), or valve reimplantation (n=2). All patients were followed up echocardiographically (cumulative follow-up, 1253 years; mean, 4\u00b13.1 years). Clinical and morphological parameters were analyzed for correlation with 10-year freedom from reoperation with the Cox proportional hazards model. Hospital mortality was 0.63%; survival was 92% at 10 years. Freedom from reoperation at 5 and 10 years was 88% and 81%; freedom from valve replacement, 95% and 84%. By univariable analysis, statistically significant predictors of reoperation were age (hazard ratio [HR]=0.97), aortoventricular diameter (HR=1.24), effective height (HR=0.76), commissural orientation (HR=0.95), use of a pericardial patch (HR=7.63), no root replacement (HR=3.80), subcommissural plication (HR=2.07), and preoperative aortic regurgitation grade 3 or greater. By multivariable analysis, statistically significant predictors for reoperation were age (HR=0.96), aortoventricular diameter (HR=1.30), effective height (HR=0.74), commissural orientation (HR=0.96), and use of a pericardial patch (HR=5.16).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions\u2014<\/jats:title>\n                    <jats:p>Reconstruction of bicuspid aortic valve can be performed reproducibly with good early results. Recurrence and progression of regurgitation, however, may occur, depending primarily on anatomic features of the valve.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circulationaha.109.934679","type":"journal-article","created":{"date-parts":[[2011,1,3]],"date-time":"2011-01-03T23:11:40Z","timestamp":1294096300000},"page":"178-185","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":314,"title":["Valve Configuration Determines Long-Term Results After Repair of the Bicuspid Aortic Valve"],"prefix":"10.1161","volume":"123","author":[{"given":"Diana","family":"Aicher","sequence":"first","affiliation":[{"name":"From the Department of Thoracic and Cardiovascular Surgery (D.A., T.K., O.A.I., B.B., H.-J.S.) and Institute of Medical Biometry, Epidemiology and Medical Informatics, (S.G.) University Hospital of Saarland, Homburg, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Kunihara","sequence":"additional","affiliation":[{"name":"From the Department of Thoracic and Cardiovascular Surgery (D.A., T.K., O.A.I., B.B., H.-J.S.) and Institute of Medical Biometry, Epidemiology and Medical Informatics, (S.G.) University Hospital of Saarland, Homburg, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar","family":"Abou Issa","sequence":"additional","affiliation":[{"name":"From the Department of Thoracic and Cardiovascular Surgery (D.A., T.K., O.A.I., B.B., H.-J.S.) and Institute of Medical Biometry, Epidemiology and Medical Informatics, (S.G.) University Hospital of Saarland, Homburg, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brigitte","family":"Brittner","sequence":"additional","affiliation":[{"name":"From the Department of Thoracic and Cardiovascular Surgery (D.A., T.K., O.A.I., B.B., H.-J.S.) and Institute of Medical Biometry, Epidemiology and Medical Informatics, (S.G.) University Hospital of Saarland, Homburg, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Gr\u00e4ber","sequence":"additional","affiliation":[{"name":"From the Department of Thoracic and Cardiovascular Surgery (D.A., T.K., O.A.I., B.B., H.-J.S.) and Institute of Medical Biometry, Epidemiology and Medical Informatics, (S.G.) University Hospital of Saarland, Homburg, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans-Joachim","family":"Sch\u00e4fers","sequence":"additional","affiliation":[{"name":"From the Department of Thoracic and Cardiovascular Surgery (D.A., T.K., O.A.I., B.B., H.-J.S.) and Institute of Medical Biometry, Epidemiology and Medical Informatics, (S.G.) University Hospital of Saarland, Homburg, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(70)90761-7"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0025-6196(12)65618-3"},{"key":"e_1_3_2_4_2","first-page":"369","article-title":"Bicuspid aortic valve: abnormal aortic elastic properties","volume":"11","author":"Nistri S","year":"2002","unstructured":"Nistri S, Sorbo MD, Basso C, Thiene G. Bicuspid aortic valve: abnormal aortic elastic properties. J Heart Valve Dis. 2002;11:369\u2013373.","journal-title":"J Heart Valve Dis"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.atv.0000055441.28842.0a"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(20)31429-X"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2004.06.035"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/0003-4975(95)00508-I"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1010-7940(99)00003-2"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.4065\/74.1.14"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2004.05.063"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(84)80080-6"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2006.11.017"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2006.04.032"},{"key":"e_1_3_2_15_2","first-page":"1305","article-title":"Le traitement de l'insuffisance aortique par'annuloplastie aortique","volume":"59","author":"Cabrol C","year":"1966","unstructured":"Cabrol C, Cabrol A, Guiraudon G, Bertrand M. Le traitement de l'insuffisance aortique par'annuloplastie aortique. Arch Mal Coeur Vaiss. 1966;59:1305\u20131322.","journal-title":"Arch Mal Coeur Vaiss"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0894-7317(03)00335-3"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2003.09.018"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.102.suppl_3.III-40"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.4065\/81.3.322"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/0003-4975(94)92212-8"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.105.001594"},{"key":"e_1_3_2_22_2","first-page":"752","article-title":"Results of valve preservation and repair for bicuspid aortic valve insufficiency","volume":"14","author":"Alsoufi B","year":"2005","unstructured":"Alsoufi B, Borger MA, Armstrong S, Maganti M, David TE. Results of valve preservation and repair for bicuspid aortic valve insufficiency. J Heart Valve Dis. 2005;14:752\u2013758.","journal-title":"J Heart Valve Dis"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2006.01.068"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(96)01231-3"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2004.08.038"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2006.03.053"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2009.06.021"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(19)35024-X"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/0003-4975(90)90240-7"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-198910000-00003"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(03)01249-9"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.54.2.179"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2007.12.033"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.100.21.2153"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2006.02.034"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2005.12.055"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2007.01.054"}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCULATIONAHA.109.934679","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T02:20:34Z","timestamp":1715566834000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCULATIONAHA.109.934679"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,1,18]]},"references-count":36,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2011,1,18]]}},"alternative-id":["10.1161\/CIRCULATIONAHA.109.934679"],"URL":"https:\/\/doi.org\/10.1161\/circulationaha.109.934679","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,1,18]]},"assertion":[{"value":"2009-12-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2010-10-25","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2011-01-03","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}