title: Comparison of diameter of ascending aorta in patients with severe aortic stenosis secondary to congenital versus degenerative versus rheumatic etiologies.
abstract: Aortic root dilation has been previously reported to be associated with aortic stenosis (AS), but data to support this statement are scarce. The dimensions of the aortic root were measured at 4 levels (annulus, sinuses, sinotubular junction, and ascending aorta) in 88 patients (mean age 71.2+/-9.7 years; 56% men) with severe AS who underwent intraoperative transesophageal echocardiography immediately before aortic valve replacement. These patients were compared with 76 gender- and age-matched patients without AS who underwent transesophageal echocardiography for various indications. The etiology of aortic valve stenosis was degenerative in 62 (70.5%), bicuspid aortic valve (BAV) in 15 (17.0%), and rheumatic in 11 (12.5%). The ascending aorta was significantly wider in AS with various etiologies (BAV, rheumatic, degenerative) than in the controls (39+/-6.9, 35.0+/-4.2, 33.1+/-4.1, and 31.3+/-3.7 mm, respectively; p<0.001). The dimensions of the sinuses and sinotubular junction were significantly less in those with AS of degenerative etiology than in the controls (29.5+/-4.0 vs 32.5+/-4.3 mm and 23.6+/-3.0 vs 26.8+/-3.0 mm, respectively, p<0.001). The prevalence of a dilated aorta (>37 mm) was 3.9%, 13.1%, 36.4%, and 60% in the control group and AS patients with degenerative, rheumatic, and BAV etiology, respectively (p<0.0001). In conclusion, patients with severe AS due to BAV had significant dilation of the aortic root. Patients with degenerative and rheumatic etiology had less remarkable dilation compared with control group, and most values were within the normal range.
authors.affiliation: Department of Cardiology, Rabin Medical Center, Beilinson Campus, Petah Tiqva, and Tel-Aviv University Sackler Faculty of Medicine, Tel Aviv, Israel.
authors.forename: Itsik
authors.initials: I
authors.lastname: Ben-Dor
authors.forename: Alex
authors.initials: A
authors.lastname: Sagie
authors.forename: Daniel
authors.initials: D
authors.lastname: Weisenberg
authors.forename: Sagit
authors.initials: S
authors.lastname: Ben Zekry
authors.forename: Avigail
authors.initials: A
authors.lastname: Fraser
authors.forename: Gideon
authors.initials: G
authors.lastname: Sahar
authors.forename: Zaza
authors.initials: Z
authors.lastname: Iakobishvili
authors.forename: Alexander
authors.initials: A
authors.lastname: Battler
authors.forename: Yaron
authors.initials: Y
authors.lastname: Shapira
mesh_terms: D000368:Aged; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging*; D001021:Aortic Valve / Q000000981:diagnostic imaging; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging* / Q000209:etiology; D004108:Dilatation, Pathologic / Q000000981:diagnostic imaging / Q000453:epidemiology; D017548:Echocardiography, Transesophageal; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012214:Rheumatic Heart Disease / Q000150:complications* / Q000000981:diagnostic imaging; D012720:Severity of Illness Index