Type A Aortic Dissection in Patients With Bicuspid Aortic Valve Aortopathy
| Autor: | Joseph E. Bavaria, Matthias Siepe, Prashanth Vallabhajosyula, Clarence Pingpoh, Friedhelm Beyersdorf, Wilson Y. Szeto, Emanuela Branchetti, Martin Czerny, Fabliha Khurshan, Maximilian Kreibich, Bartosz Rylski, Nimesh D. Desai |
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| Rok vydání: | 2018 |
| Předmět: |
Pulmonary and Respiratory Medicine
Aortic valve Male medicine.medical_specialty Radiography Aortic Diseases Heart Valve Diseases 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Bicuspid aortic valve Aneurysm Bicuspid Aortic Valve Disease Internal medicine medicine.artery Ascending aorta medicine Humans In patient Aged Retrospective Studies Aortic dissection business.industry Retrospective cohort study Middle Aged medicine.disease Aortic Dissection medicine.anatomical_structure 030228 respiratory system Aortic Valve cardiovascular system Cardiology Surgery Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | The Annals of thoracic surgery. 109(1) |
| ISSN: | 1552-6259 |
| Popis: | The aim of this study was to evaluate clinical, aortic, and outcome characteristics of type A aortic dissection patients with bicuspid aortic valves (BAVs) and tricuspid aortic valves (TAVs).Patient characteristics and radiographic, operative, and outcome data were evaluated and compared between 1068 TAV patients and 72 BAV patients operated on for type A aortic dissection in 2 centers. Predissection aortic diameters were calculated as previously reported for TAV patients.BAV patients were significantly younger (P.001) and had a lower incidence of cardiovascular risk factors. Although the clinical presentation was similar, the dissection affected the abdominal aorta significantly more often in TAV patients (P = .029). Aortic root replacements were performed significantly more often in BAV patients (P.001). Postoperative outcome was similar between the 2 groups. BAV patients had a significantly larger maximum postdissection diameter (P.001) and calculated predissection diameter (P.001) compared with TAV patients. Predissection ascending aortic diameters were less than 5.5 cm in 96% of all TAV patients and less than 5.0 cm in 76% of all BAV patients.Acute type A aortic dissection in BAV patients is not associated with worse clinical or long-term outcome but significantly influences the proximal aortic repair. After modeling predissection aortic diameters, less than 5% of all TAV patients and possibly less than 25% of all BAV patients would meet the elective threshold for preventative replacement of the ascending aorta. |
| Databáze: | OpenAIRE |
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