In Reply We highly appreciate the interest of Svensson and colleagues in our recent study1 on bicuspid aortic valve (BAV) repair, and we congratulate them on their own achievements in this field of cardiac surgery.
Svensson et al reported that aortic valve repair with or without concomitant aortic replacement has become their routine approach in patients with pure aortic regurgitation (AR). For almost 1200 patients with BAV, in the absence of severe aortic stenosis, we recently reported similar results showing that valve preservation has been achieved in approximately 90% of patients.2 Valve replacement is thus the exception, with cusp calcification and endocarditis being the most frequent causes.2 Both entities have repeatedly been identified as predictors of repair failure.1,3,4
Schneider U, Schöpe J, Schäfers H. Advances in Aortic Valve Repair, Particularly Bicuspid Valves—Reply. JAMA Cardiol. 2021;6(8):978–979. doi:10.1001/jamacardio.2021.1248
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