| Determinants of ascending aortic dimensions after aortic valve replacement with a stented bioprosthesis. | |
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MedLine Citation:
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PMID: 17315379 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND AIM OF THE STUDY: Concomitant replacement of the mildly dilated ascending aorta during aortic valve replacement (AVR) is controversial because progress of aortic dilatation is uncertain after elimination of the valvular lesion. The study aim was to determine factors influencing the aortic dimensions, to analyze their clinical impact, and to identify criteria for concomitant surgery on the aorta. METHODS: Between February 1994 and May 1999, 100 patients with tricuspid aortic valve disease received the stented porcine Mosaic prosthesis within a FDA approval study. Follow up (mean 4.8 years; range: 0.1-8.8 years; total 483.4 patient-years) included documentation of adverse events and transthoracic echocardiography with measurements of the aortic sinus, sinotubular junction, and ascending aorta. RESULTS: Baseline aortic dimensions were dependent on gender and body surface area, but independent of the type and extent of valvular lesion, patient age, and atherosclerotic risk factors. Larger baseline aortic diameters were associated with smaller postoperative annual aortic expansion rates (r = -0.47, p <0.001). In patients with baseline aortic dilatation > or =40 mm (10.2%; mean 42.5+/-2.6 mm), aortic diameter decreased during follow up (p = 0.032; expansion rate -1.9+/-2.0 mm/year). Baseline aortic dilatation did not influence postoperative morbidity and mortality. Prosthetic regurgitation was associated with increases in aortic diameter (p <0.001). Survival was reduced in patients with aortic expansion rates >3.6 mm/year (0.0% versus 68.2+/-9.7%; p <0.001). CONCLUSION: AVR without concomitant surgery on the aorta in patients with mild aortic dilatation is feasible, as aortic diameters were decreased after removal of the diseased valve. The aortic expansion rate had a strong prognostic importance, even on aortic diameters, which are considered to be within normal ranges. |
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Authors:
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Florian Botzenhardt; Ellen Hoffmann; Bernhard M Kemkes; Brigitte Gansera |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Multicenter Study |
Journal Detail:
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Title: The Journal of heart valve disease Volume: 16 ISSN: 0966-8519 ISO Abbreviation: J. Heart Valve Dis. Publication Date: 2007 Jan |
Date Detail:
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Created Date: 2007-02-23 Completed Date: 2007-03-06 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9312096 Medline TA: J Heart Valve Dis Country: England |
Other Details:
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Languages: eng Pagination: 19-26 Citation Subset: IM |
Affiliation:
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Department of Cardiology, Staedtisches Klinikum Muenchen, Klinikum Bogenhausen, Munich, Germany. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Aorta / pathology, physiopathology, ultrasonography* Aortic Aneurysm / etiology Aortic Valve Insufficiency / complications, surgery Aortic Valve Stenosis / complications, surgery Bioprosthesis* Body Weights and Measures Dilatation, Pathologic Echocardiography Female Heart Valve Diseases / complications, surgery* Heart Valve Prosthesis* Heart Valve Prosthesis Implantation / instrumentation* Humans Male Middle Aged Prospective Studies Stents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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