The development of ascending aortic aneurysms after elective aortic valve replacement with St Jude mechanical valve prosthesis in the bicuspid patient: a pilot study.
The association between bicuspid aortic valve (BAV) and ascending aorta aneurysm is well described. Replacement of the ascending aorta is now being considered at 4.5 cm. We identified patients confirmed with BAV who underwent elective aortic valve replacement (AVR) with a mechanical St Jude Bioprosthesis from 1994 to 2000 who were ≤65 years of age at the time of surgery. Follow-up imaging was obtained by computed tomography (CT) angiography or echocardiography. A total of 225 patients who underwent AVR were identified; 60 patients had a BAV. Of all, 36 (60%) patients with BAV returned for follow-up imaging of their ascending aorta. Eight patients (22%) had diameters classifiable as aneurysmal (>4.5 cm) that developed within 9.6 ± 4.1 years from implant and requiring surgery. Of all, 7 patients (12%) died within 5.9 ± 2.5 years from their implant date. Lifelong serial monitoring of the ascending aorta for patients with BAV should be the standard of care.
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN 55905, USA. Cohoon.kevin@mayo.edu
Kevin P
KP
Cohoon
Jillian
J
Foley
Robert S
RS
Dieter
Mamdouh
M
Bakhos
Jeffrey
J
Schwartz
D000328:Adult; D001014:Aortic Aneurysm / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D001021:Aortic Valve / Q000002:abnormalities*; D001705:Bioprosthesis; D015331:Cohort Studies; D017558:Elective Surgical Procedures; D005260:Female; D006349:Heart Valve Diseases / Q000151:congenital / Q000175:diagnosis / Q000601:surgery*; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D015995:Prevalence; D016896:Treatment Outcome