Grant: Travel Awards - Institute Community Support

Bicuspid aortic valve (BAV) is the most frequent congenital cardiac malformation with up to 2% of global population being affected. This aortic valve morphology abnormality generally leads to severe aortic valve disease (AVD). Up to this day, no medical treatment as yet show any efficiency to prevent or slow down the progression of AVD. Thus, surgical valve replacement remains the mainstay therapy for patient with severe and symptomatic AVD. In young adults, the implantation of a mechanical valvular prostheses is the recommended option according to the medicine guidelines. Indeed, considering that biological prostheses durability is limited, mechanical prostheses appear to be the best option to reduce reoperation risks. However, the high thrombogene potential inherent to mechanical valves forces the instauration of a life-long anticoagulation therapy which increases major bleeding event hazards. The Ross procedure is a particular surgery in aortic valve diseases consisting in a two-valve surgery. At first, the diseased aortic valve of one patient is removed and replaced by the patient's own pulmonary valve (autograft). Then, an homograft is being installed to replace the pulmonary valve that was moved in aortic position. This procedure is frequently performed in pediatric surgery since the pulmonary autograft is able to grow following the child's development. Moreover, it has been shown that autograft durability tends to surpass those of bioprostheses and the absence of need of anticoagulation treatment. These are substantial advantages because they reduce reoperation and events risks and increase daily quality of life for these patients. Yet, surgeons remain reluctant to perform this complicated procedure. In order to bring deeper insights on this technique, we sought to determine predictors of the pulmonary homograft and autograft degeneration to improve patients clinical management and long-term procedural success rate.