Assessment of Computed Tomography Imaging for Isolated Type 1 Bicuspid Aortic Valve Repair: A Comparison between Internal and External Suture Annuloplasty Techniques

Background: The ideal position of suture annuloplasty relative to the aortic annulus (internal or external) remains unclear. This study aimed investigate effectiveness internal and external for isolated type 1 bicuspid valve (BAV) repair. Electrocardiogram (ECG)-gated computed tomography (CT) was used compare two techniques analyze their impact on annulus. Methods: We retrospectively analyzed 20 patients who underwent BAV repair with either annuloplasty. Each group included 10 comparable clinical features. Preoperative postoperative ECG-gated CT scans were performed assess anatomical relationship between ventricular-aortic junction (VAJ) virtual basal ring (VBR), measure height from VBR at predefined landmarks in both groups. Perioperative annular geometries, including area perimeter, measured quantify expansibility. discrepancy dimension size Hegar dilator compared groups evaluate Results: In groups, VAJ higher than right coronary (RC) ostium (7.7 ± 3.3 mm) raphe (7.9 1.5 mm). shared a similar pattern RC (5.3 1.1 mm 4.8 1.0 mm, respectively). contrast, differences minimal these group. Postoperative expansibility decreased preoperative levels (4.9 2.3% vs. 8.9 5.5%, p = 0.038), while no significant change found (7.6 4.1% 6.5 2.8%, 0.473). showed less systole (10.1 3.7% 30.1 16.6%, 0.004) diastole (5.7 4.9% 20.9 14.5%, 0.009) Conclusions: Internal results better positioning due absence interference. While this more precise reduction short term, long-term follow-up evaluation is necessary its effectiveness.