title: Aortic expansion rate in patients with dilated post-stenotic ascending aorta submitted only to aortic valve replacement long-term follow-up.
abstract: OBJECTIVE
  This study was conceived to describe the evolution of aortic dimensions in patients with moderate post-stenotic ascending aorta dilation (50 to 59 mm) submitted to aortic valve replacement (AVR) alone.
  
  
  BACKGROUND
  The appropriate treatment of post-stenotic ascending aorta dilation has been poorly investigated.
  
  
  METHODS
  Ninety-three patients affected by severe isolated calcific aortic valve stenosis in the tricuspid aortic valve accompanied by moderate dilation of the ascending aorta (50 to 59 mm) were submitted to AVR only. All patients were followed for a mean of 14.7 ± 4.8 years by means of periodic clinical evaluations and echocardiography and tomography scans of the thorax.
  
  
  RESULTS
  Operative mortality was 1.0% (1 patient). During the follow-up, 16 patients died and 2 had to be reoperated for valve dysfunction. No patients experienced acute aortic events (rupture, dissection, pseudoaneurysm), and no patient had to be reoperated on the aorta. There was not a substantial increase in aortic dimensions: mean aortic diameter was 57 ± 11 mm at the end of the follow-up versus 56 ± 02 mm pre-operatively (p = NS). The mean ascending aorta expansion rate was 0.3 ± 0.2 mm/year.
  
  
  CONCLUSIONS
  In the absence of connective tissue disorders, AVR alone is sufficient to prevent further aortic expansion in patients with moderate post-stenotic dilation of the ascending aorta. Aortic replacement can probably be reserved for patients with a long life expectancy.
authors.affiliation: Department of Cardiac Surgery, Catholic University, Rome. mgaudino@tiscali.it
authors.forename: Mario
authors.initials: M
authors.lastname: Gaudino
authors.forename: Amedeo
authors.initials: A
authors.lastname: Anselmi
authors.forename: Mauro
authors.initials: M
authors.lastname: Morelli
authors.forename: Claudio
authors.initials: C
authors.lastname: Pragliola
authors.forename: Vasileios
authors.initials: V
authors.lastname: Tsiopoulos
authors.forename: Franco
authors.initials: F
authors.lastname: Glieca
authors.forename: Gianfederico
authors.initials: G
authors.lastname: Possati
mesh_terms: D000368:Aged; D000783:Aneurysm / Q000473:pathology; D001011:Aorta / Q000473:pathology* / Q000503:physiopathology*; D001021:Aortic Valve / Q000473:pathology / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000601:surgery*; D050197:Atherosclerosis / Q000473:pathology; D002309:Cardiology / Q000379:methods; D003251:Constriction, Pathologic / Q000473:pathology; D004452:Echocardiography / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome