TY - JOUR
T1 - Aortic complications after bicuspid aortic valve replacement
T2 - Long-term results
AU - Russo, Claudio F.
AU - Mazzetti, Simone
AU - Garatti, Andrea
AU - Ribera, Elena
AU - Milazzo, Angela
AU - Bruschi, Giuseppe
AU - Lanfranconi, Marco
AU - Colombo, Tiziano
AU - Vitali, Ettore
PY - 2002/11/1
Y1 - 2002/11/1
N2 - Background. Bicuspid aortic valve (BAV) is a risk factor for aortic dissection and aneurysm. We studied patients with BAV and tricuspid aortic valve (TAV) to evaluate long-term changes in the ascending aorta after aortic valve replacement (AVR). Patients and Methods. One hundred consecutive patients were allocated into two groups according to the presence of BAV (group A, 50 patients) or TAV (group B, 50 patients). Mean age was 51 ± 12 years in group A, and 50 ± years 12 in group B. No patients had hypertension or Marfan's syndrome. Until July 2001, mean follow-up was 234 ± 47 months in group A and 241 ± 43 months in group B. Results. Five patients (10%, CL 5.7 to 13.9) in group A suffered late acute aortic dissection. Acute aortic dissection (5 vs 0, p = 0.0001) and sudden death (7 vs 0, p = 0.0001) occurred more frequently in patients with BAV. All survivors were assessed by echocardiogram. The mean diameter of the ascending aorta was 48.4 mm in group A and 36.8 mm in group B. Three patients in group A were operated on because of ascending aorta aneurysm more than 6 cm in diameter. Conclusions. As a result of our experience, we recommend a policy of prophylactic replacement of even a seemingly normal and definitely a mildly enlarged ascending aorta in cases of BAV at the moment of AVR, and consideration of a similar approach for any other cardiac surgical procedure in patients with BAV.
AB - Background. Bicuspid aortic valve (BAV) is a risk factor for aortic dissection and aneurysm. We studied patients with BAV and tricuspid aortic valve (TAV) to evaluate long-term changes in the ascending aorta after aortic valve replacement (AVR). Patients and Methods. One hundred consecutive patients were allocated into two groups according to the presence of BAV (group A, 50 patients) or TAV (group B, 50 patients). Mean age was 51 ± 12 years in group A, and 50 ± years 12 in group B. No patients had hypertension or Marfan's syndrome. Until July 2001, mean follow-up was 234 ± 47 months in group A and 241 ± 43 months in group B. Results. Five patients (10%, CL 5.7 to 13.9) in group A suffered late acute aortic dissection. Acute aortic dissection (5 vs 0, p = 0.0001) and sudden death (7 vs 0, p = 0.0001) occurred more frequently in patients with BAV. All survivors were assessed by echocardiogram. The mean diameter of the ascending aorta was 48.4 mm in group A and 36.8 mm in group B. Three patients in group A were operated on because of ascending aorta aneurysm more than 6 cm in diameter. Conclusions. As a result of our experience, we recommend a policy of prophylactic replacement of even a seemingly normal and definitely a mildly enlarged ascending aorta in cases of BAV at the moment of AVR, and consideration of a similar approach for any other cardiac surgical procedure in patients with BAV.
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U2 - 10.1016/S0003-4975(02)04261-3
DO - 10.1016/S0003-4975(02)04261-3
M3 - Article
C2 - 12440663
AN - SCOPUS:0036841414
VL - 74
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
SN - 0003-4975
IS - 5
ER -