Bicuspid aortic valve (BAV) repair includes repairing the BAV by reshaping the aortic valve leaflets, allowing the valve to open and close easily. However, the long-term results of BAV repair are unknown. This study aims to evaluate the long-term stability of BAV repair.

This case series included a total of 1,024 patients who underwent BAV repair for aortic regurgitation or aneurysm. Systematic modifications in anatomic principles-based techniques were applied for the last 727 participants. The included patients underwent BAV with or without concomitant aortic replacement and postoperative clinical follow-up. The primary outcomes of the study were the survival and incidence of reoperation or recurrent aortic regurgitation.

The survival rate at 15 years was 82.1% among the 1,024 patients included in the study. The cumulative incidence of reoperation was discovered to be 30.7% at the time of follow-up. The time to reoperation was associated with cusp classification (hazard ratio 1.78), asymmetric commissural orientation (HR 1.95), and the use of the pericardial patch for cusp repair (5.25). The incidence of reoperation in patients who received the anatomic repair concept reduced significantly after 10 years.

The research concluded that survival after BAV repair was found to be promising, and the BAV repairs were considered stable.