“Peninsula-Style” Transverse Aortic Arch Replacement in Patients With Bicuspid Aortic Valve

• Published in: The Annals of thoracic surgery Vol. 90; no. 4; pp. 1369 - 1371
• Main Authors: Itoh, Akinobu, MD, Fischbein, Michael, MD, PhD, Arata, Koji, CCP, Miller, David Craig, MD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.10.2010; Elsevier
• Subjects: Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Aorta, Thoracic - surgery; Aortic Aneurysm - surgery; Aortic Valve - abnormalities; Biological and medical sciences; Blood Vessel Prosthesis Implantation - methods; Cardiology. Vascular system; Cardiothoracic Surgery; Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava; Endocardial and cardiac valvular diseases; Heart; Heart Valve Diseases - surgery; Heart Valve Prosthesis Implantation - methods; Humans; Medical sciences; Middle Aged; Pneumology; Surgery; 26; Human; Cardiac valvular disease; Aortic arch; Bicuspid aortic valve; Cardiovascular disease; Anesthesia; Patient; Replacement; Circulatory system; Cardiology; Congenital disease
• ISSN: 0003-4975; 1552-6259
• DOI: 10.1016/j.athoracsur.2009.11.029

Although the optimal surgical treatment of the dilated aortic arch is controversial in patients with a bicuspid aortic valve, such exists in more than 70% of bicuspid aortic valve patients. Aortic wall histologic abnormalities are present from the aortic root to the distal arch regardless of aortic size. We describe a simple “peninsula-style” technique of transverse arch replacement used in conjunction with valve-sparing aortic root replacement for patients with a bicuspid aortic valve. This provides resection of the entire dilated thoracic aorta, preserving the arch branches in continuity with the proximal descending aorta.