BACKGROUND: Aortic dilatation is common among adults with bicuspid aortic valves (BAV). Predictors of risk and progression of aortic dilatation are not well described in this setting. METHODS: We analyzed retrospective data on the presence of dilation in several aortic segments in 156 adult patients with BAV who had serial echocardiograms performed at least 1 year apart. Various risk factors for the presence and progression of aortic dilatation were identified. RESULTS: Mean echocardiographic follow-up was 3.8 +/- 1.4 years, yielding a total of 582 patient-years. Independent predictors of having a dilated aorta at baseline were age (odds ratio [OR] 1.06, 95% CI 1.03-1.09), body surface area (OR 8.78, 95% CI 1.08-71.70) and moderate to severe aortic regurgitation (OR 6.38, 95% CI 2.51-16.20). During echocardiographic follow-up, 16 (15.2%) patients developed dilatation (incidence 4 cases per 100 patient-years). Mean annual rates of progression were estimated at 0.37 mm (95% CI 0.17-0.57), 0.18 mm (95% CI 0.05-0.31), 0.17 mm (95% CI 0.06-0.29) and 0.18 mm (95% CI 0.05-0.31) for the ascending aorta, sinotubular junction, aortic sinus and aortic annulus, respectively. Fusion of the right and left valve leaflets was associated with rapid aortic dilatation (OR 2.92, 95% CI 1.15- 7.41) whereas prior coarctation repair was associated with protection from rapid aortic dilatation (OR 0.13, 95% CI 0.04-0.40). CONCLUSIONS: Patients with BAV and increased age, high body surface area and moderate to severe aortic regurgitation are more likely to have a dilated aorta. Patients with right-to-left leaflet fusion are at increased risk of rapid aortic dilatation.
BACKGROUND: Aortic dilatation is common among adults with bicuspid aortic valves (BAV). Predictors of risk and progression of aortic dilatation are not well described in this setting. METHODS: We analyzed retrospective data on the presence of dilation in several aortic segments in 156 adult patients with BAV who had serial echocardiograms performed at least 1 year apart. Various risk factors for the presence and progression of aortic dilatation were identified. RESULTS: Mean echocardiographic follow-up was 3.8 +/- 1.4 years, yielding a total of 582 patient-years. Independent predictors of having a dilated aorta at baseline were age (odds ratio [OR] 1.06, 95% CI 1.03-1.09), body surface area (OR 8.78, 95% CI 1.08-71.70) and moderate to severe aortic regurgitation (OR 6.38, 95% CI 2.51-16.20). During echocardiographic follow-up, 16 (15.2%) patients developed dilatation (incidence 4 cases per 100 patient-years). Mean annual rates of progression were estimated at 0.37 mm (95% CI 0.17-0.57), 0.18 mm (95% CI 0.05-0.31), 0.17 mm (95% CI 0.06-0.29) and 0.18 mm (95% CI 0.05-0.31) for the ascending aorta, sinotubular junction, aortic sinus and aortic annulus, respectively. Fusion of the right and left valve leaflets was associated with rapid aortic dilatation (OR 2.92, 95% CI 1.15- 7.41) whereas prior coarctation repair was associated with protection from rapid aortic dilatation (OR 0.13, 95% CI 0.04-0.40). CONCLUSIONS:Patients with BAV and increased age, high body surface area and moderate to severe aortic regurgitation are more likely to have a dilated aorta. Patients with right-to-left leaflet fusion are at increased risk of rapid aortic dilatation.
Authors: Tsuyoshi Kaneko; Prem Shekar; Vladimir Ivkovic; Nicholas T Longford; Chuan-Chin Huang; Martin I Sigurdsson; Robert C Neely; Maroun Yammine; Julius I Ejiofor; Vanessa Montiero Vieira; Jasmine T Shahram; Karam M Habchi; Gregory W Malzberg; Peter S Martin; Jordan Bloom; Eric M Isselbacher; J Daniel Muehlschlegel; Thoralf M Sundt; Simon C Body Journal: Eur J Cardiothorac Surg Date: 2018-03-01 Impact factor: 4.191
Authors: Brian Lima; Judson B Williams; S Dave Bhattacharya; Asad A Shah; Nicholas Andersen; Andrew Wang; J Kevin Harrison; G Chad Hughes Journal: J Heart Valve Dis Date: 2011-07
Authors: Alexander P Taylor; Ajay Yadlapati; Adin-Cristian Andrei; Zhi Li; Colleen Clennon; Patrick M McCarthy; James D Thomas; S Chris Malaisrie; Neil J Stone; Robert O Bonow; Paul W M Fedak; Jyothy J Puthumana Journal: Clin Cardiol Date: 2015-12-22 Impact factor: 2.882
Authors: Alexia Rossi; Denise van der Linde; Sing Chien Yap; Thomas Lapinskas; Sharon Kirschbaum; Tirza Springeling; Maarten Witsenburg; Judith Cuypers; Adriaan Moelker; Gabriel P Krestin; Arie van Dijk; Mark Johnson; Robert-Jan van Geuns; Jolien W Roos-Hesselink Journal: Eur Radiol Date: 2012-09-26 Impact factor: 5.315
Authors: Karam M Habchi; Elena Ashikhmina; Vanessa Montiero Vieira; Jasmin T Shahram; Eric M Isselbacher; Thoralf M Sundt; Prem Shekar; Jochen D Muehlschlegel; Simon C Body Journal: Int J Cardiovasc Imaging Date: 2016-11-12 Impact factor: 2.357