Patients with a bicuspid aortic valve (BAV) are at increased risk of valvular regurgitation compared to their counterparts with a tri-leaflet aortic valve. There is now increasing emphasis to offer BAV repair to mitigate the risks of prosthesis-related complications, including thromboembolism, hemorrhage and endocarditis, as well as structural valve deterioration and future reoperation with conventional valve replacement, particularly in younger populations. Furthermore, over the preceding two decades, our greater understanding of the functional anatomy of the BAV, pathophysiological mechanisms of BAV insufficiency, and the development of a functional classification of aortic regurgitation have significantly contributed to the evolution of aortic valve reconstructive surgery. In this commentary, we discuss a recent article from the Journal of Cardiac Surgery comparing external annuloplasty and subcommissural annuloplasty as techniques for BAV repair.

中文翻译：

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二尖瓣主动脉瓣修复中的外部或联合下瓣环成形术：哪个更好？

与具有三叶主动脉瓣的患者相比，具有二尖瓣主动脉瓣 (BAV) 的患者瓣膜反流的风险增加。现在越来越重视提供 BAV 修复，以降低假体相关并发症的风险，包括血栓栓塞、出血和心内膜炎，以及结构性瓣膜恶化和未来通过常规瓣膜置换进行再手术的风险，尤其是在年轻人群中。此外，在过去的二十年中，我们对 BAV 的功能解剖、BAV 功能不全的病理生理机制以及主动脉瓣关闭不全功能分类的发展有了更深入的了解，这些都对主动脉瓣重建手术的发展做出了重大贡献。在这篇评论中，我们讨论了来自心脏外科杂志比较了外部瓣环成形术和合缝下瓣环成形术作为 BAV 修复技术。