TY - JOUR
T1 - Is aortic wall degeneration related to bicuspid aortic valve anatomy in patients with valvular disease?
AU - Russo, Claudio F.
AU - Cannata, Aldo
AU - Lanfranconi, Marco
AU - Vitali, Ettore
AU - Garatti, Andrea
AU - Bonacina, Edgardo
PY - 2008/10
Y1 - 2008/10
N2 - Objective: Patients with bicuspid aortic valve are at increased risk for aortic complications. Methods: A total of 115 consecutive patients with bicuspid aortic valve disease underwent surgery of the ascending aorta. We classified the cusp configuration by 3 types: fusion of left coronary and right coronary cusps (type A), fusion of right coronary and noncoronary cusps (type B), and fusion of left coronary and noncoronary cusps (type C). Histopathologic changes in the ascending aortic wall were graded (aortic wall score). Results: We observed type A fusion in 85 patients (73.9%), type B fusion in 28 patients (24.3%), and type C fusion in 2 patients (1.8%). Patients with type A fusion were younger at operation than patients with type B fusion (51.3 ± 15.5 years vs 58.7 ± 7.6 years, respectively; P = .034). The mean ascending aorta diameter was 48.9 ± 5.0 mm and 48.7 ± 5.7 mm in type A and type B fusion groups, respectively (P = .34). The mean aortic root diameter was significantly larger in type A fusion (4.9 ± 6.7 mm vs 32.7 ± 2.8 mm; P <.0001). The aortic wall score was significantly higher in type A fusion than in type B fusion (P = .02). The prevalence of aortic wall histopathologic changes was significantly higher in type A fusion. Moreover, there were no statistically significant differences between type A and type B fusion in terms of prevalence of bicuspid aortic valve stenosis, regurgitation, or mixed disease. Conclusion: In diseased bicuspid aortic valves, there was a statistically significant association between type A valve anatomy and a more severe degree of wall degeneration in the ascending aorta and dilatation of the aortic root at younger age compared with type B valve anatomy.
AB - Objective: Patients with bicuspid aortic valve are at increased risk for aortic complications. Methods: A total of 115 consecutive patients with bicuspid aortic valve disease underwent surgery of the ascending aorta. We classified the cusp configuration by 3 types: fusion of left coronary and right coronary cusps (type A), fusion of right coronary and noncoronary cusps (type B), and fusion of left coronary and noncoronary cusps (type C). Histopathologic changes in the ascending aortic wall were graded (aortic wall score). Results: We observed type A fusion in 85 patients (73.9%), type B fusion in 28 patients (24.3%), and type C fusion in 2 patients (1.8%). Patients with type A fusion were younger at operation than patients with type B fusion (51.3 ± 15.5 years vs 58.7 ± 7.6 years, respectively; P = .034). The mean ascending aorta diameter was 48.9 ± 5.0 mm and 48.7 ± 5.7 mm in type A and type B fusion groups, respectively (P = .34). The mean aortic root diameter was significantly larger in type A fusion (4.9 ± 6.7 mm vs 32.7 ± 2.8 mm; P <.0001). The aortic wall score was significantly higher in type A fusion than in type B fusion (P = .02). The prevalence of aortic wall histopathologic changes was significantly higher in type A fusion. Moreover, there were no statistically significant differences between type A and type B fusion in terms of prevalence of bicuspid aortic valve stenosis, regurgitation, or mixed disease. Conclusion: In diseased bicuspid aortic valves, there was a statistically significant association between type A valve anatomy and a more severe degree of wall degeneration in the ascending aorta and dilatation of the aortic root at younger age compared with type B valve anatomy.
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U2 - 10.1016/j.jtcvs.2007.11.072
DO - 10.1016/j.jtcvs.2007.11.072
M3 - Article
C2 - 18954633
AN - SCOPUS:54049119325
VL - 136
SP - 937
EP - 942
JO - Journal of Thoracic and Cardiovascular Surgery
JF - Journal of Thoracic and Cardiovascular Surgery
SN - 0022-5223
IS - 4
ER -