Late post-AVR progression of bicuspid aortopathy: link to hemodynamics
Standard
Late post-AVR progression of bicuspid aortopathy: link to hemodynamics. / Naito, Shiho; Gross, Tatiana; Disha, Kushtrim; von Kodolitsch, Yskert; Reichenspurner, Hermann; Girdauskas, Evaldas.
In: GEN THORAC CARDIOVAS, Vol. 65, No. 5, 05.2017, p. 252-258.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Late post-AVR progression of bicuspid aortopathy: link to hemodynamics
AU - Naito, Shiho
AU - Gross, Tatiana
AU - Disha, Kushtrim
AU - von Kodolitsch, Yskert
AU - Reichenspurner, Hermann
AU - Girdauskas, Evaldas
PY - 2017/5
Y1 - 2017/5
N2 - BACKGROUND AND AIM OF THE STUDY: The ascending aortic dilatation may progress after aortic valve replacement (AVR) in bicuspid aortic valve (BAV) patients. Our aim was to evaluate rheological flow patterns and histological characteristics of the aneurysmal aorta in BAV patients at the time of reoperative aortic surgery.MATERIALS AND METHODS: 13 patients (mean age: 42 ± 9 years, 10 (77%) male) with significant progression of proximal aortopathy after isolated AVR surgery for BAV disease (i.e., 16.7 ± 8.1 years post-AVR) were identified by cardiac phase-contrast cine magnetic resonance imaging (MRI) in our hospital. A total of nine patients (69%) underwent redo aortic surgery. Based on the MRI data, the aortic area of the maximal flow-induced stress (jet sample) and the opposite site (control sample) were identified and corresponding samples were collected intraoperatively. Histological sum-score values [i.e. aortic wall changes were graded based on a summation of seven histological criteria (each scored from 0 to 3)] were compared between these samples.RESULTS: Mean proximal aortic diameter at MRI follow-up was 55 ± 6 mm (range 47-66mm). Preoperative cardiac MRI demonstrated eccentric systolic flow pattern directed towards right-lateral/right posterior wall of the proximal aorta in 9/13 (69%) patients. Histological sum-score values were significantly higher in the jet sample vs control sample (i.e., 8.3 ± 3.8 vs 5.6 ± 2.4, respectively, p = 0.04).CONCLUSIONS: Hemodynamic factors may still be involved in the late progression of bicuspid aortopathy even after isolated AVR surgery for BAV disease.
AB - BACKGROUND AND AIM OF THE STUDY: The ascending aortic dilatation may progress after aortic valve replacement (AVR) in bicuspid aortic valve (BAV) patients. Our aim was to evaluate rheological flow patterns and histological characteristics of the aneurysmal aorta in BAV patients at the time of reoperative aortic surgery.MATERIALS AND METHODS: 13 patients (mean age: 42 ± 9 years, 10 (77%) male) with significant progression of proximal aortopathy after isolated AVR surgery for BAV disease (i.e., 16.7 ± 8.1 years post-AVR) were identified by cardiac phase-contrast cine magnetic resonance imaging (MRI) in our hospital. A total of nine patients (69%) underwent redo aortic surgery. Based on the MRI data, the aortic area of the maximal flow-induced stress (jet sample) and the opposite site (control sample) were identified and corresponding samples were collected intraoperatively. Histological sum-score values [i.e. aortic wall changes were graded based on a summation of seven histological criteria (each scored from 0 to 3)] were compared between these samples.RESULTS: Mean proximal aortic diameter at MRI follow-up was 55 ± 6 mm (range 47-66mm). Preoperative cardiac MRI demonstrated eccentric systolic flow pattern directed towards right-lateral/right posterior wall of the proximal aorta in 9/13 (69%) patients. Histological sum-score values were significantly higher in the jet sample vs control sample (i.e., 8.3 ± 3.8 vs 5.6 ± 2.4, respectively, p = 0.04).CONCLUSIONS: Hemodynamic factors may still be involved in the late progression of bicuspid aortopathy even after isolated AVR surgery for BAV disease.
KW - Adolescent
KW - Adult
KW - Aortic Aneurysm, Thoracic/diagnosis
KW - Aortic Valve/abnormalities
KW - Aortic Valve Stenosis/physiopathology
KW - Bicuspid Aortic Valve Disease
KW - Disease Progression
KW - Female
KW - Follow-Up Studies
KW - Heart Valve Diseases/complications
KW - Heart Valve Prosthesis Implantation/adverse effects
KW - Hemodynamics
KW - Humans
KW - Magnetic Resonance Imaging, Cine
KW - Male
KW - Middle Aged
KW - Prospective Studies
KW - Reoperation
KW - Time Factors
KW - Young Adult
U2 - 10.1007/s11748-017-0746-4
DO - 10.1007/s11748-017-0746-4
M3 - SCORING: Journal article
C2 - 28194732
VL - 65
SP - 252
EP - 258
JO - GEN THORAC CARDIOVAS
JF - GEN THORAC CARDIOVAS
SN - 1863-6705
IS - 5
ER -
