BACKGROUND AND AIM OF THE STUDY: The study aim was to compare the pattern and rate of aortic dilation in patients with isolated non-surgical bicuspid aortic valve (BAV) with left-right fusion (L-R) and right-non coronary fusion (R-N). Although the etiology and optimal management of aortic dilation associated with BAV remain the subject of debate, recent data have suggested that L-R and R-N cusp fusion phenotypes represent distinct pathological entities. METHODS: Consecutive patients with BAV and at least two echocardiographic assessments made between 2006 and 2012 were reviewed. Patients with hemodynamically significant valvular disease, aortic aneurysm (> 50 mm) or unrepaired aortic coarctation were excluded. Longitudinal analyses of the aortic annulus, sinuses of Valsalva, sinotubular junction and ascending aortic diameters were performed using mixed-effect models. RESULTS: A total of 590 echocardiographic studies was analyzed in 212 patients (mean age 33 ± 14 years), of which 147 had L-R phenotype and 65 had R-N phenotype. The median follow up was 3.6 years. Baseline aortic diameters at the sinuses of Valsalva were larger in patients with L-R compared to R-N fusion (33.8 ± 5.3 mm versus 30.8 ± 4.8 mm; p < 0.001). At this level, the rate of aortic dilation was higher with L-R versus R-N fusion (0.41 ± 0.11 mm/year versus 0.01 ± 0.08 mm/year; p < 0.001). The rate of proximal ascending aortic dilation was also higher with L-R versus R-N fusion (0.58 ± 0.08 mm/year versus 0.18 ± 0.09 mm/year; p < 0.001). CONCLUSION: Aortic dilation rates vary according to the pattern of BAV cusp fusion, with faster rates of aortic sinus and ascending aortic dilation associated with the L-R compared to R-N phenotype.
BACKGROUND AND AIM OF THE STUDY: The study aim was to compare the pattern and rate of aortic dilation in patients with isolated non-surgical bicuspid aortic valve (BAV) with left-right fusion (L-R) and right-non coronary fusion (R-N). Although the etiology and optimal management of aortic dilation associated with BAV remain the subject of debate, recent data have suggested that L-R and R-N cusp fusion phenotypes represent distinct pathological entities. METHODS: Consecutive patients with BAV and at least two echocardiographic assessments made between 2006 and 2012 were reviewed. Patients with hemodynamically significant valvular disease, aortic aneurysm (> 50 mm) or unrepaired aortic coarctation were excluded. Longitudinal analyses of the aortic annulus, sinuses of Valsalva, sinotubular junction and ascending aortic diameters were performed using mixed-effect models. RESULTS: A total of 590 echocardiographic studies was analyzed in 212 patients (mean age 33 ± 14 years), of which 147 had L-R phenotype and 65 had R-N phenotype. The median follow up was 3.6 years. Baseline aortic diameters at the sinuses of Valsalva were larger in patients with L-R compared to R-N fusion (33.8 ± 5.3 mm versus 30.8 ± 4.8 mm; p < 0.001). At this level, the rate of aortic dilation was higher with L-R versus R-N fusion (0.41 ± 0.11 mm/year versus 0.01 ± 0.08 mm/year; p < 0.001). The rate of proximal ascending aortic dilation was also higher with L-R versus R-N fusion (0.58 ± 0.08 mm/year versus 0.18 ± 0.09 mm/year; p < 0.001). CONCLUSION: Aortic dilation rates vary according to the pattern of BAV cusp fusion, with faster rates of aortic sinus and ascending aortic dilation associated with the L-R compared to R-N phenotype.
Authors: Mina F Hanna; Nagina Malguria; Sachin S Saboo; Kirk G Jordan; Michael Landay; Brian B Ghoshhajra; Suhny Abbara Journal: Diagn Interv Radiol Date: 2017 Sep-Oct Impact factor: 2.630
Authors: Sebastian Albinsson; Alessandro Della Corte; Azra Alajbegovic; Katarzyna K Krawczyk; Ciro Bancone; Umberto Galderisi; Marilena Cipollaro; Marisa De Feo; Amalia Forte Journal: Heart Vessels Date: 2017-01-19 Impact factor: 2.037
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
Authors: Michael A Borger; Paul W M Fedak; Elizabeth H Stephens; Thomas G Gleason; Evaldas Girdauskas; John S Ikonomidis; Ali Khoynezhad; Samuel C Siu; Subodh Verma; Michael D Hope; Duke E Cameron; Donald F Hammer; Joseph S Coselli; Marc R Moon; Thoralf M Sundt; Alex J Barker; Michael Markl; Alessandro Della Corte; Hector I Michelena; John A Elefteriades Journal: J Thorac Cardiovasc Surg Date: 2018-08 Impact factor: 5.209