Aortic Expansion Rate in Patients With Dilated Post-Stenotic Ascending Aorta Submitted Only to Aortic Valve Replacement
| Autor: | Claudio Pragliola, Mauro Morelli, Franco Glieca, Vasileios Tsiopoulos, Gian Federico Possati, Mario Gaudino, Amedeo Anselmi |
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| Rok vydání: | 2011 |
| Předmět: |
Aortic valve
medicine.medical_specialty Aorta business.industry Calcific aortic valve stenosis medicine.disease Surgery medicine.anatomical_structure Aneurysm Aortic valve replacement Internal medicine Aortic valve stenosis medicine.artery Ascending aorta cardiovascular system medicine Ventricular pressure Cardiology Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of the American College of Cardiology. 58:581-584 |
| ISSN: | 0735-1097 |
| DOI: | 10.1016/j.jacc.2011.03.040 |
| Popis: | Objectives This study was conceived to describe the evolution of aortic dimensions in patients with moderate post-stenotic ascending aorta dilation (50 to 59 mm) submitted to aortic valve replacement (AVR) alone. Background The appropriate treatment of post-stenotic ascending aorta dilation has been poorly investigated. Methods Ninety-three patients affected by severe isolated calcific aortic valve stenosis in the tricuspid aortic valve accompanied by moderate dilation of the ascending aorta (50 to 59 mm) were submitted to AVR only. All patients were followed for a mean of 14.7 ± 4.8 years by means of periodic clinical evaluations and echocardiography and tomography scans of the thorax. Results Operative mortality was 1.0% (1 patient). During the follow-up, 16 patients died and 2 had to be reoperated for valve dysfunction. No patients experienced acute aortic events (rupture, dissection, pseudoaneurysm), and no patient had to be reoperated on the aorta. There was not a substantial increase in aortic dimensions: mean aortic diameter was 57 ± 11 mm at the end of the follow-up versus 56 ± 02 mm pre-operatively (p = NS). The mean ascending aorta expansion rate was 0.3 ± 0.2 mm/year. Conclusion In the absence of connective tissue disorders, AVR alone is sufficient to prevent further aortic expansion in patients with moderate post-stenotic dilation of the ascending aorta. Aortic replacement can probably be reserved for patients with a long life expectancy. |
| Databáze: | OpenAIRE |
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