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FASCICOLI E ARTICOLI   I PIÙ LETTI   eTOC

ULTIMO FASCICOLOTHE JOURNAL OF CARDIOVASCULAR SURGERY

Rivista di Chirurgia Cardiaca, Vascolare e Toracica

Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,632

Periodicità: Bimestrale

ISSN 0021-9509

Online ISSN 1827-191X

 

The Journal of Cardiovascular Surgery 2013 Ottobre;54(5):653-9

CARDIAC SECTION 

 ORIGINAL ARTICLES

Increased risk of late aortic events after isolated aortic valve replacement in patients with bicuspid aortic valve insufficiency versus stenosis

Girdauskas E. 1, Disha K. 1, Secknus M. 2, Borger M. 3, Kuntze T. 1

1 Department of Cardiac Surgery Heart Center, Leipzig, Germany;
2 Department of Cardiology Central Clinic Bad Berka, Germany;
3 Department of Cardiac Surgery Heart Center, Leipzig, Germany

Aim: Bicuspid aortic valve (BAV) is a very heterogeneous disorder and risk of aortic events in BAV may be influenced by phenotype of the disease. Correlation has been proposed between aortic dilatation patterns and functional status of the BAV (i.e., stenosis versus insufficiency). The aim of our study was to evaluate the risk of late aortic events after isolated aortic valve replacement (AVR) in patients with BAV stenosis versus insufficiency.
Methods: Review of our institutional BAV database identified 442 consecutive BAV patients (mean age 55±12 years, 76% men), who underwent isolated AVR from 1995 through 2005. A subgroup of 376 (85%) patients presented with an isolated/predominant BAV stenosis (Group I), whereas 66 (15%) patients had an isolated BAV insufficiency (Group II). Follow-up information (a total of 3864 patient-years) was 100% complete. Mean follow-up period was 9.4±3.9 years. Adverse aortic events were defined as the need for proximal aortic surgery or the occurrence of aortic dissection/rupture, or sudden death during follow-up.
Results: Actuarial survival rates in Group I and Group II were 86±2% vs. 94±3% at 10 years, and 76±3% vs. 85±6% at 15 years, respectively (P=0.2). Proximal aortic surgery was performed in 6 (1.5%) patients in Group I vs. 2 (3%) patients in Group II. Freedom from proximal aortic re-interventions was 95±3% in Group I vs. 90±8% in Group II at 15 years after AVR (P=0.4). Aortic dissection/rupture occurred in 2 patients in Group II. Freedom from late adverse aortic events was 93±3% in Group I vs. 78±9% in Group II at 15 years postoperatively (P=0.02).
Conclusion: BAV patients with isolated valve insufficiency are at increased risk of late aortic events, as compared with BAV stenosis patients at 15 years after AVR.

lingua: Inglese


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