Bicuspid aortic valve related aortopathy

Stock, S.; Mohamed, Salah A.; Sievers, Hans‐Hinrich

doi:10.1007/s11748-017-0821-x

Cited by 26 publications

(13 citation statements)

References 71 publications

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“…Although it is generally believed that elder patients are more susceptible to mid ascending aortic dilatation, while younger patients are more likely to show dilatation of the annulus and aortic root, there is not a consensus regarding the correlation of age and dilatation, with some studies recommending a customized surgical intervention for each patient [ 37 , 38 ].…”

Section: ⧉ Discussionmentioning

confidence: 99%

Therapeutic approach comparison in bicuspid aortic valve aortopathy and clinical practice implications

Dima

Streian

Gaşpar³

et al. 2021

Rom J Morphol Embryol

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Bicuspid aortic valve (BAV) is the most common heart valve malformation, and it may be associated with the development of long-term complications, such as aortic stenosis (AS) secondary to valvular calcification and aortic insufficiency (AI), with or without ascending aortic aneurysm (AAA). This study was performed at the Institute of Cardiovascular Diseases, Timişoara, Romania, from 2015 through 2018 and included a total of 105 patients with BAV. Out of the 105 BAV patients, 14 displayed AAA, alongside either AS or AI, and were selected undergo aortic valve replacement (AVR) alongside surgical replacement or aortoplasty of the ascending aorta, and the elastic fiber loss in the ascending aortic wall was evaluated for each patient. Two surgical interventions used alongside AVR in BAV patients with AAA and AS or AI were compared in this study: reduction ascending aortoplasty (RAA) and ascending aorta replacement (AAR). Postoperative follow-ups have shown RAA is useful short-term but that, in contrast to AAR, it leads to aortic redilatation over time. These results can contribute to a major future meta-analysis with the goal of improving the current clinical practice guidelines for BAV aortopathy.

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Section: ⧉ Discussionmentioning

confidence: 99%

Therapeutic approach comparison in bicuspid aortic valve aortopathy and clinical practice implications

Dima

Streian

Gaşpar³

et al. 2021

Rom J Morphol Embryol

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“…In physiological conditions, the diameter of the ascending aorta will gradually increase with age in both healthy individuals and bicuspid aortic valves. 19,20…”

Section: Discussionmentioning

confidence: 99%

Mid-term follow-up of aortic valve replacement for bicuspid aortic valve

Liu

et al. 2021

Cardiol Young

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Objective: The purpose of this study was to evaluate the mid-term outcome of aortic valve replacement for bicuspid aortic valve and tricuspid aortic valve and the related risk factors. Methods: From January 2014 to June 2019, 177 tricuspid aortic valve patients and 101 bicuspid aortic valve patients who underwent aortic valve replacement in our hospital were collected. 1:1 propensity score matching analysis was used to control the bias in patient selection. The perioperative and follow-up data between the two groups were compared. Independent risk factors which were associated with the continued dilatation of the ascending aorta were identified by univariate or multivariate logistic regression analysis. Results: After the matching procedure, 160 patients were included in the analysis (80 in each group). Baseline characteristics, intraoperative, and perioperative outcomes were similar between the two groups (all p > 0.05). Moreover, 67 patients in the tricuspid aortic valve group and 70 in the bicuspid aortic valve group completed the follow-up. The ascending aorta change, annual change rate, and the proportion of continuous dilation of ascending aorta in bicuspid aortic valve group were significantly higher than those in the tricuspid aortic valve group (p < 0.05). Multivariate logistic regression analysis showed that type 1 in bicuspid aortic valve (OR 5.173; 95% CI 1.772, 15.101; p = 0.003), aortic regurgitation (OR 3.673; 95% CI 1.133, 11.908; p = 0.030), and aortic valve stenosis with regurgitation (OR 6.489; 95% CI 1.726, 24.404; p = 0.006) were independent risk factors for the continued dilatation of the ascending aorta in all AV patients. Furthermore, the multivariate logistic regression analysis showed that type 1 in bicuspid aortic valve (OR 5.157; 95% CI 1.053, 25.272; p = 0.043), age ≥ 40 years (OR 6.956; 95% CI 1.228, 39.410; p = 0.028), and aortic regurgitation (OR 4.322; 95% CI 1.174, 15.911; p = 0.028) were independent risk factors for the continued dilatation of the ascending aorta in bicuspid aortic valve patients. Conclusion: Compared with tricuspid aortic valve patients, the ascending aorta of bicuspid aortic valve patients is more likely to continue to enlarge after aortic valve replacement. Type 1 in bicuspid aortic valve, age ≥ 40 years, and aortic regurgitation were the independent risk factors.

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“…BAV is the most common congenital cardiac anomaly 1 and its correlation with thoracic aortic disease is well established, so as to be defined "BAV aortopathy." 9,10 Within thoracic aortic aneurysm, supracoronary ascending aorta dilatation results to be the prevalent phenotype. 2,3,11 In our cohort the most common BAV phenotype were BAV Type 0 antero-posterior (55/75, 73%) and BAV Type 1 left-right (17/75, 23%), these results do not differ from the findings by Sievers et al 12 who had previously investigated the association with BAV phenotype and aortic configuration.…”

Section: Commentmentioning

confidence: 99%

Fate of mild‐to‐moderate bicuspid aortic valve disease untreated during ascending aorta replacement

et al. 2021

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Background Bicuspid aortic valve (BAV) is the most common congenital heart defect and it is responsible for an increased risk of developing aortic valve and ascending aorta complications. In case of mild to moderate BAV disease in patients undergoing supracoronary ascending aorta replacement, it is unclear whether a concomitant aortic valve replacement should be performed. Methods From June 2002 to January 2020, 75 patients with mild‐to‐moderate BAV regurgitation (±mild‐to‐moderate stenosis) who underwent isolated supracoronary ascending aorta replacement were retrospectively analyzed. Clinical and echocardiographic follow‐up was 100% complete (mean: 7.4 ± 3.9 years, max: 16.4). Kaplan–Meier estimates were employed to analyze long‐term survival. Cumulative incidence function (CIF) for time to reoperation, recurrence of aortic regurgitation (AR) ≥3+ and aortic stenosis (AS) greater than moderate, with death as competing risk, were computed. Results There was no hospital mortality and no cardiac death occurred. Overall survival at 12 years was 97.4 ± 2.5%, 95% confidence interval (CI: 83.16–99.63). At follow‐up there were no cases of aortic root surgery whereas three patients underwent AV replacement. At 12 years the CIF of reoperation was 2.6 ± 2.5%, 95% CI [0.20–11.53]. At follow‐up, AR 3+/4+ was present in 1 pt and AS greater than moderate in 3. At 12 years the CIF of AR more than 2+/4+ was 5.1 ± 4.98% and of AS more than moderate 6.9 ± 3.8%. Conclusions In our study mild to moderate regurgitation of a BAV did not do significantly worse at least up to 10 years after isolated supracoronary ascending aorta replacement.

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Bicuspid aortic valve related aortopathy

Cited by 26 publications

References 71 publications

Therapeutic approach comparison in bicuspid aortic valve aortopathy and clinical practice implications

Therapeutic approach comparison in bicuspid aortic valve aortopathy and clinical practice implications

Mid-term follow-up of aortic valve replacement for bicuspid aortic valve

Fate of mild‐to‐moderate bicuspid aortic valve disease untreated during ascending aorta replacement

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