Document Detail


Risk of aortic root or ascending aorta complications in patients with bicuspid aortic valve with and without coarctation of the aorta.
MedLine Citation:
PMID:  19766771     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The actual incidence of ascending aorta complications (AACs) in adults with bicuspid aortic valve (BAV) and the role of associated coarctation of the aorta (COA) as an independent risk factor for AACs remain unknown. From the Adult Congenital Heart Disease database at La Paz Hospital, 631 patients in whom a BAV was diagnosed by echocardiography or surgical inspection since December 1989 were identified. These patients were then further subdivided into 2 groups according to the presence of an associated COA. AACs included aortic aneurysms (ascending aorta > or =55 mm) and aortic dissection, rupture, or perforation. Patients with a BAV and COA had a greater prevalence of AACs (8.0%) than those with an isolated BAV (3.7%; p = 0.037). The coexistence of COA was the only significant predictor of AACs (odds ratio 4.7, 95% confidence interval 1.5 to 15; p = 0.01). From the total patient group with a BAV, the clinical and echocardiographic data were reviewed for 341 patients without an AAC at baseline (97 with and 244 without COA) who had undergone serial examinations >1 year apart. The median follow-up was 7 years (interquartile range 3.5 to 10.2; total 2,436 patient-years). A new AAC occurred in 13 patients (0.5/100 patient-years). The incidence of AACs was 1.3/100 patient-years in the COA group versus 0.2/100 patient-years in the non-COA group (hazard ratio 7.5, 95% confidence interval 2.0 to 28, p = 0.002). All acute aortic events (dissection or rupture) at follow-up occurred in patients with a BAV and COA. In conclusion, the long-term incidence of AACs in patients with isolated BAV is low, but patients with BAV and associated COA are at increased risk.
Authors:
Jose Maria Oliver; Rafael Alonso-Gonzalez; Ana Elvira Gonzalez; Pastora Gallego; Angel Sanchez-Recalde; Emilio Cuesta; Angel Aroca; Jose Luis Lopez-Sendon
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  104     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-09-21     Completed Date:  2009-10-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1001-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology, La Paz University Hospital, Madrid, Spain. joliver.hulp@salud.madrid.org
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MeSH Terms
Descriptor/Qualifier:
Abnormalities, Multiple / epidemiology,  ultrasonography
Adolescent
Adult
Analysis of Variance
Aneurysm, Dissecting / epidemiology,  etiology*,  ultrasonography
Aneurysm, Ruptured / epidemiology,  etiology*,  ultrasonography
Aorta / surgery,  ultrasonography
Aortic Coarctation / complications*,  surgery,  ultrasonography
Aortic Valve / abnormalities*,  surgery
Cohort Studies
Echocardiography, Doppler
Female
Heart Aneurysm / etiology*,  mortality,  surgery,  ultrasonography
Heart Defects, Congenital / complications,  ultrasonography
Humans
Incidence
Logistic Models
Male
Middle Aged
Mitral Valve / surgery,  ultrasonography
Multivariate Analysis
Probability
Retrospective Studies
Risk Assessment
Survival Analysis
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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