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Are normal-sized ascending aortas at risk of late aortic events after aortic valve replacement for bicuspid aortic valve disease?

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Are normal-sized ascending aortas at risk of late aortic events after aortic valve replacement for bicuspid aortic valve disease? / Disha, Kushtrim; Rouman, Mina; Secknus, Maria-Anna; Kuntze, Thomas; Girdauskas, Evaldas.

In: INTERACT CARDIOV TH, Vol. 22, No. 4, 04.2016, p. 465-471.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Disha, K, Rouman, M, Secknus, M-A, Kuntze, T & Girdauskas, E 2016, 'Are normal-sized ascending aortas at risk of late aortic events after aortic valve replacement for bicuspid aortic valve disease?', INTERACT CARDIOV TH, vol. 22, no. 4, pp. 465-471. https://doi.org/10.1093/icvts/ivv387

APA

Disha, K., Rouman, M., Secknus, M-A., Kuntze, T., & Girdauskas, E. (2016). Are normal-sized ascending aortas at risk of late aortic events after aortic valve replacement for bicuspid aortic valve disease? INTERACT CARDIOV TH, 22(4), 465-471. https://doi.org/10.1093/icvts/ivv387

Vancouver

Disha K, Rouman M, Secknus M-A, Kuntze T, Girdauskas E. Are normal-sized ascending aortas at risk of late aortic events after aortic valve replacement for bicuspid aortic valve disease? INTERACT CARDIOV TH. 2016 Apr;22(4):465-471. https://doi.org/10.1093/icvts/ivv387

Bibtex

@article{3919c82e642043c39360ca0caef38a75,
title = "Are normal-sized ascending aortas at risk of late aortic events after aortic valve replacement for bicuspid aortic valve disease?",
abstract = "OBJECTIVES: Bicuspid aortic valve (BAV)-associated aortopathy has been proposed to progress after isolated aortic valve replacement (AVR) surgery, which has been traditionally used as an argument against a TAVR procedure in this clinical subset. Still, more than half of BAV patients have a normal-sized proximal aorta at the time of AVR surgery. We aimed to analyse the long-term risk of adverse aortic events after isolated conventional AVR surgery for BAV and normal-sized proximal aorta.METHODS: A total of 200 consecutive patients (mean age 56 ± 13 years, 73% men) with BAV disease and ascending aortic diameter of <40 mm underwent isolated conventional AVR from 1995 through 2008 and were identified from our institutional BAV database. Long-term follow-up data (a total of 1532 patient-years) were obtained for all hospital survivors. Composite adverse aortic/cardiovascular events were defined as the need for redo aortic surgery, the occurrence of aortic dissection/rupture, or sudden cardiac death during follow-up.RESULTS: A total of 25 (13%) patients died after a mean follow-up of 8.5 ± 5 years post-AVR surgery, which resulted in an overall survival rate of 75 ± 6 and 87 ± 7% at 15 years postoperatively, for BAV-aortic stenosis and BAV-aortic regurgitation, respectively (P = 0.6). An adverse aortic event occurred in 1 (0.5%) study patient, while 5 (2.5%) further patients suffered sudden cardiac death. Only 1 patient required redo aortic surgery. No documented aortic dissection/rupture occurred. Redo AVR surgery due to endocarditis or structural valve degeneration was performed in 6 (3%) patients. The rate of freedom from composite adverse events was 92 ± 5 and 95 ± 4% at 15 years, for the AS and AR subgroups, respectively (P = 0.7).CONCLUSIONS: BAV patients with aortic valve dysfunction and normal-sized ascending aorta are at considerably low risk of late adverse aortic events after isolated AVR.",
keywords = "Adolescent, Adult, Aged, Aged, 80 and over, Aneurysm, Dissecting/diagnosis, Aortic Aneurysm/diagnosis, Aortic Rupture/diagnosis, Aortic Valve/abnormalities, Aortic Valve Insufficiency/diagnosis, Aortic Valve Stenosis/diagnosis, Bicuspid Aortic Valve Disease, Databases, Factual, Death, Sudden, Cardiac/etiology, Female, Heart Valve Diseases/complications, Heart Valve Prosthesis Implantation/adverse effects, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Proportional Hazards Models, Reoperation, Retrospective Studies, Risk Assessment, Risk Factors, Time Factors, Treatment Outcome, Young Adult",
author = "Kushtrim Disha and Mina Rouman and Maria-Anna Secknus and Thomas Kuntze and Evaldas Girdauskas",
note = "{\textcopyright} The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.",
year = "2016",
month = apr,
doi = "10.1093/icvts/ivv387",
language = "English",
volume = "22",
pages = "465--471",
journal = "INTERACT CARDIOV TH",
issn = "1569-9293",
publisher = "European Association for Cardio-Thoracic Surgery",
number = "4",

}

RIS

TY - JOUR

T1 - Are normal-sized ascending aortas at risk of late aortic events after aortic valve replacement for bicuspid aortic valve disease?

AU - Disha, Kushtrim

AU - Rouman, Mina

AU - Secknus, Maria-Anna

AU - Kuntze, Thomas

AU - Girdauskas, Evaldas

N1 - © The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

PY - 2016/4

Y1 - 2016/4

N2 - OBJECTIVES: Bicuspid aortic valve (BAV)-associated aortopathy has been proposed to progress after isolated aortic valve replacement (AVR) surgery, which has been traditionally used as an argument against a TAVR procedure in this clinical subset. Still, more than half of BAV patients have a normal-sized proximal aorta at the time of AVR surgery. We aimed to analyse the long-term risk of adverse aortic events after isolated conventional AVR surgery for BAV and normal-sized proximal aorta.METHODS: A total of 200 consecutive patients (mean age 56 ± 13 years, 73% men) with BAV disease and ascending aortic diameter of <40 mm underwent isolated conventional AVR from 1995 through 2008 and were identified from our institutional BAV database. Long-term follow-up data (a total of 1532 patient-years) were obtained for all hospital survivors. Composite adverse aortic/cardiovascular events were defined as the need for redo aortic surgery, the occurrence of aortic dissection/rupture, or sudden cardiac death during follow-up.RESULTS: A total of 25 (13%) patients died after a mean follow-up of 8.5 ± 5 years post-AVR surgery, which resulted in an overall survival rate of 75 ± 6 and 87 ± 7% at 15 years postoperatively, for BAV-aortic stenosis and BAV-aortic regurgitation, respectively (P = 0.6). An adverse aortic event occurred in 1 (0.5%) study patient, while 5 (2.5%) further patients suffered sudden cardiac death. Only 1 patient required redo aortic surgery. No documented aortic dissection/rupture occurred. Redo AVR surgery due to endocarditis or structural valve degeneration was performed in 6 (3%) patients. The rate of freedom from composite adverse events was 92 ± 5 and 95 ± 4% at 15 years, for the AS and AR subgroups, respectively (P = 0.7).CONCLUSIONS: BAV patients with aortic valve dysfunction and normal-sized ascending aorta are at considerably low risk of late adverse aortic events after isolated AVR.

AB - OBJECTIVES: Bicuspid aortic valve (BAV)-associated aortopathy has been proposed to progress after isolated aortic valve replacement (AVR) surgery, which has been traditionally used as an argument against a TAVR procedure in this clinical subset. Still, more than half of BAV patients have a normal-sized proximal aorta at the time of AVR surgery. We aimed to analyse the long-term risk of adverse aortic events after isolated conventional AVR surgery for BAV and normal-sized proximal aorta.METHODS: A total of 200 consecutive patients (mean age 56 ± 13 years, 73% men) with BAV disease and ascending aortic diameter of <40 mm underwent isolated conventional AVR from 1995 through 2008 and were identified from our institutional BAV database. Long-term follow-up data (a total of 1532 patient-years) were obtained for all hospital survivors. Composite adverse aortic/cardiovascular events were defined as the need for redo aortic surgery, the occurrence of aortic dissection/rupture, or sudden cardiac death during follow-up.RESULTS: A total of 25 (13%) patients died after a mean follow-up of 8.5 ± 5 years post-AVR surgery, which resulted in an overall survival rate of 75 ± 6 and 87 ± 7% at 15 years postoperatively, for BAV-aortic stenosis and BAV-aortic regurgitation, respectively (P = 0.6). An adverse aortic event occurred in 1 (0.5%) study patient, while 5 (2.5%) further patients suffered sudden cardiac death. Only 1 patient required redo aortic surgery. No documented aortic dissection/rupture occurred. Redo AVR surgery due to endocarditis or structural valve degeneration was performed in 6 (3%) patients. The rate of freedom from composite adverse events was 92 ± 5 and 95 ± 4% at 15 years, for the AS and AR subgroups, respectively (P = 0.7).CONCLUSIONS: BAV patients with aortic valve dysfunction and normal-sized ascending aorta are at considerably low risk of late adverse aortic events after isolated AVR.

KW - Adolescent

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Aneurysm, Dissecting/diagnosis

KW - Aortic Aneurysm/diagnosis

KW - Aortic Rupture/diagnosis

KW - Aortic Valve/abnormalities

KW - Aortic Valve Insufficiency/diagnosis

KW - Aortic Valve Stenosis/diagnosis

KW - Bicuspid Aortic Valve Disease

KW - Databases, Factual

KW - Death, Sudden, Cardiac/etiology

KW - Female

KW - Heart Valve Diseases/complications

KW - Heart Valve Prosthesis Implantation/adverse effects

KW - Humans

KW - Kaplan-Meier Estimate

KW - Male

KW - Middle Aged

KW - Proportional Hazards Models

KW - Reoperation

KW - Retrospective Studies

KW - Risk Assessment

KW - Risk Factors

KW - Time Factors

KW - Treatment Outcome

KW - Young Adult

U2 - 10.1093/icvts/ivv387

DO - 10.1093/icvts/ivv387

M3 - SCORING: Journal article

C2 - 26803325

VL - 22

SP - 465

EP - 471

JO - INTERACT CARDIOV TH

JF - INTERACT CARDIOV TH

SN - 1569-9293

IS - 4

ER -