title: Progression rate of ascending aortic dilation in patients with normally functioning bicuspid and tricuspid aortic valves.
abstract: Dilation of the ascending aorta (AA), which is disproportionate to associated valvular lesions, is a relatively well-recognized phenomenon in patients with a bicuspid aortic valve (BAV). The aim of this study was to evaluate the rate of changes in the AA dimensions and the outcome in patients with AA dilation and BAVs compared with patients with AA dilation and tricuspid aortic valves (TAVs). Serial transesophageal echocardiograms (>12 months apart) were performed in 113 consecutive patients (BAV, n=27 and TAV, n=86) with AA diameters of >or=40 and <or=60 mm, respectively, without associated significant aortic valve stenosis or regurgitation. Baseline diameters at the sinuses of Valsalva (SV), the sinotubular junction (STJ), and the tubular tract (TT) were similar in both groups (41.3+/-5.3 vs 42.3+/-6.3 mm, p=NS, 37.8+/-5.2 vs 38.7+/-5.5 mm, p=NS, and 47.3+/-5.3 vs 45.9+/-5.1, p=NS, respectively). During an average 3-year follow-up, the rate of AA diameter progression was similar for the BAV and TAV groups (0.86+/-0.81 vs 0.82+/-1.1 mm/year, p=NS for the SV; 1.06+/-1.6 vs 0.63+/-1.1 mm/year, p=NS for the STJ; and 0.81+/-1.1 vs 0.75+/-1.1 mm/year, p=NS for the TT, respectively). Three patients in the TAV group experienced cardiac death (2 died suddenly and 1 after emergency surgery for AA dissection); there was no occurrence of cardiac death in the BAV group. In conclusion, the rate of progression of AA aneurysms was similar in patients with BAVs and in those with TAVs. Furthermore, patients with BAVs did not have increased rates of AA related complications compared with patients with TAVs.
authors.affiliation: Department of Cardiac Surgery, San Raffaele University Hospital, Milan, Italy. lacanna.giovanni@hsr.it
authors.forename: Giovanni
authors.initials: G
authors.lastname: La Canna
authors.forename: Eleonora
authors.initials: E
authors.lastname: Ficarra
authors.forename: Elefteria
authors.initials: E
authors.lastname: Tsagalau
authors.forename: Matilde
authors.initials: M
authors.lastname: Nardi
authors.forename: Antonella
authors.initials: A
authors.lastname: Morandini
authors.forename: Alaide
authors.initials: A
authors.lastname: Chieffo
authors.forename: Francesco
authors.initials: F
authors.lastname: Maisano
authors.forename: Ottavio
authors.initials: O
authors.lastname: Alfieri
mesh_terms: D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging* / Q000503:physiopathology; D018450:Disease Progression; D017548:Echocardiography, Transesophageal; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000502:physiology*; D011379:Prognosis; D011446:Prospective Studies; D014261:Tricuspid Valve / Q000000981:diagnostic imaging / Q000502:physiology*