Luc Cozijnsen1, Hester J van der Zaag-Loonen2, Martinus A Cozijnsen3, Richard L Braam4, Robin H Heijmen5, Barbara J M Mulder6. 1. Department of Cardiology, Gelre Hospital, Apeldoorn, Netherlands. Electronic address: l.cozijnsen@gelre.nl. 2. Department of Epidemiology, Gelre Hospital, Apeldoorn, Netherlands. 3. Department of Paediatric Gastroenterology and Hepatology, Erasmus Medical Centre, Rotterdam, Netherlands. 4. Department of Cardiology, Gelre Hospital, Apeldoorn, Netherlands. 5. Department of Cardiothoracic surgery, St Antonius Hospital, Nieuwegein, Netherlands. 6. Department of Cardiology, Academic Medical Centre, Amsterdam, Netherlands.
Abstract
BACKGROUND: After aortic valve replacement (AVR), bicuspid aortic valve (BAV) patients continue to be at risk of aortic complications. Therefore, knowledge of native valve anatomy is important for follow-up. We aimed to determine the extent of which the presence of BAV disease is known in a regional post-AVR population. METHODS: The Electronical Medical Record system was used to collect all patients under follow-up after AVR. We documented their clinical data and used the operative report to determine valve phenotype; lacking reports were retrieved. RESULTS: We identified 560 patients who underwent AVR between 1971 and 2012, with a median of 6.2years follow-up postoperatively. Mean age at surgery was 66years (SD13.2years), and 319 patients (57%) were male. In 29 cases (5%), an operative report was not available and in 85 patients (16%) the report lacked a description of valve phenotype. In 446 patients, a surgeon's description of native valve was available: 299 patients (67%) had tricuspid aortic valve, 140 (31%) BAV, and 3 (1%) quadricuspid aortic valve. In 4 patients (1%) the description was non-conclusive. In 66/140 BAV patients the surgeon's diagnosis was not reported back to the referring cardiologist, which corresponded with 12% of all 560 AVR patients. Another 21% of these 560 lacked a clear description of native valve anatomy: no report, no native valve description or an unclear valve description. CONCLUSIONS: Native valve anatomy was not known in one-third of AVR patients under follow-up, which included almost half of the BAV patients. This lack of knowledge withholds patients from appropriate ascending aorta surveillance.
BACKGROUND: After aortic valve replacement (AVR), bicuspid aortic valve (BAV) patients continue to be at risk of aortic complications. Therefore, knowledge of native valve anatomy is important for follow-up. We aimed to determine the extent of which the presence of BAV disease is known in a regional post-AVR population. METHODS: The Electronical Medical Record system was used to collect all patients under follow-up after AVR. We documented their clinical data and used the operative report to determine valve phenotype; lacking reports were retrieved. RESULTS: We identified 560 patients who underwent AVR between 1971 and 2012, with a median of 6.2years follow-up postoperatively. Mean age at surgery was 66years (SD13.2years), and 319 patients (57%) were male. In 29 cases (5%), an operative report was not available and in 85 patients (16%) the report lacked a description of valve phenotype. In 446 patients, a surgeon's description of native valve was available: 299 patients (67%) had tricuspid aortic valve, 140 (31%) BAV, and 3 (1%) quadricuspid aortic valve. In 4 patients (1%) the description was non-conclusive. In 66/140 BAV patients the surgeon's diagnosis was not reported back to the referring cardiologist, which corresponded with 12% of all 560 AVR patients. Another 21% of these 560 lacked a clear description of native valve anatomy: no report, no native valve description or an unclear valve description. CONCLUSIONS: Native valve anatomy was not known in one-third of AVR patients under follow-up, which included almost half of the BAV patients. This lack of knowledge withholds patients from appropriate ascending aorta surveillance.
Authors: L Cozijnsen; R L Braam; M Bakker-de Boo; A M Otten; J G Post; T Schermer; B J Bouma; B J M Mulder Journal: Neth Heart J Date: 2021-09-02 Impact factor: 2.380