Document Detail


Stentless aortic valve replacement in patients with bicuspid aortic valve disease: clinical outcome and aortic diameter changes during follow-up.
MedLine Citation:
PMID:  20227289     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
OBJECTIVE: A bicuspid aortic valve (BAV) may be associated with an aortopathy affecting clinical outcome. Our aim was to assess long-term outcome and analyse if progressive aortic dilatation occurs with time in patients with BAV disease who underwent stentless valve replacement.
METHODS: Demographic, operative and clinical data were retrospectively reviewed. Patients were classified according to whether their native aortic valve was identified as tricuspid (TC) or bicuspid (BC) at the time of AVR. Serial transthoracic echocardiography was used to measure changes in ascending aortic diameter over time. Propensity adjustment and multivariate regression were used. Events over time were assessed using the Kaplan-Meier method, and the determinants of events were assessed with the Cox proportional-hazards model.
RESULTS: Between January 1991 and January 2001, 215 patients underwent AVR. They had a serial follow-up echocardiography performed for a mean of 6.1+/-4.3 years postoperatively. Ninety patients (41%) had a BAV, and the BC group was younger (BC 62+/-15 years vs TC 71+/-12 years; p=0.002). We found no difference in the increase in ascending aortic diameter over follow-up (BC 0.1+/-0.5 cm vs TC 0.0+/-0.5 cm; p=0.34). BC morphology was not an independent predictor of increased overall mortality (propensity-adjusted hazard ratio: 0.79; 95% confidence interval (CI): 0.42-1.44; p=0.44) or increased risk of reoperation (propensity adjusted hazard ration: 1.84; 95% CI: 0.88-3.36; p=0.11).
CONCLUSION: Stentless AVR is protective against progressive aortic aneurysmal disease and confers excellent clinical outcomes in patients with BAV and normal preoperative ascending aortic diameter.
Authors:
Ayyaz Ali; Amit Patel; Ziad A Ali; Yasir Abu-Omar; Darren Freed; Ahmad Y Sheikh; Thanos Athanasiou; John Pepper
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Publication Detail:
Type:  Journal Article     Date:  2010-03-12
Journal Detail:
Title:  European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery     Volume:  38     ISSN:  1873-734X     ISO Abbreviation:  Eur J Cardiothorac Surg     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  134-40     Citation Subset:  IM    
Copyright Information:
Copyright 2010 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.
Affiliation:
Department of Cardiothoracic Surgery, Royal Brompton Hospital, London SW3 3NP, UK. ayyaz75@gmail.com
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