Clinical Outcome and Echocardiographic Predictors of Aortic Valve Replacement in Patients with Bicuspid Aortic Valve
| Autor: | Judith Therrien, Igal A. Sebag, Caroline Michel, Anne D. Walling, Lawrence G. Rudski, George N. Honos, Shaheeda Ahmed |
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| Rok vydání: | 2007 |
| Předmět: |
Adult
Male Canada medicine.medical_specialty Aortic Valve Insufficiency Hemodynamics Risk Assessment Bicuspid aortic valve Aortic valve replacement Risk Factors Internal medicine Outcome Assessment Health Care Humans Medicine Ventricular outflow tract Radiology Nuclear Medicine and imaging Aged Aged 80 and over Heart Valve Prosthesis Implantation business.industry Hazard ratio Middle Aged Prognosis medicine.disease Survival Analysis Confidence interval Cardiac surgery Surgery Survival Rate Stenosis Treatment Outcome Aortic Valve Heart Valve Prosthesis cardiovascular system Cardiology Female Cardiology and Cardiovascular Medicine business Echocardiography Transesophageal |
| Zdroj: | Journal of the American Society of Echocardiography. 20:998-1003 |
| ISSN: | 0894-7317 |
| Popis: | Clinical outcomes and echocardiographic parameters associated with aortic valve replacement (AVR) for bicuspid aortic valve are scarce.We conducted retrospective analysis of 208 adults with bicuspid aortic valve referred for transthoracic echocardiograms.The Kaplan-Meier survival free of death or need for cardiac surgery was 72% at 5 years. Cardiac surgery was performed in 19%, the majority (68%) for symptomatic aortic stenosis. Peak gradient 80 mm Hg or greater (hazard ratio 11.8, 95% confidence interval 3.7-37.8, P.0001) and aortic valve area less than or equal to 0.75 cm(2) (hazard ratio 2.9, 95% confidence interval 1.0-8.5, P = .05) predicted the need for AVR. Patients with a large (54%) versus normal left ventricular outflow tract dimension underwent AVR for symptomatic aortic stenosis at a larger calculated aortic valve area (1.07 +/- 0.21 vs 0.75 +/- 0.18 cm(2), P.0001) but at a similar peak gradient and velocity ratio (76 +/- 19 vs 76 +/- 22 mm Hg, P = not significant; 0.23 +/- 0.06 vs 0.26 +/- 0.12, P = not significant, respectively).Clinical events are common among patients with bicuspid aortic valve. Peak gradient 80 mm Hg or more and aortic valve area less than or equal to 0.75 cm(2) predicts the need for AVR. Gradients and velocity ratio better reflect the hemodynamic burden of aortic stenosis in patients with a large left ventricular outflow tract. |
| Databáze: | OpenAIRE |
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