title: Ascending aortic wall cohesion: comparison of bicuspid and tricuspid valves.
abstract: Objectives. Bicuspid aortic valve (AV) represents the most common form of congenital AV malformation, which is frequently associated with pathologies of the ascending aorta. We compared the mechanical properties of the aortic wall between patients with bicuspid and tricuspid AV using a new custom-made device mimicking transversal aortic wall shear stress. Methods. Between 03/2010 and 07/2011, 190 consecutive patients undergoing open aortic valve replacement at our institution were prospectively enrolled, presenting either with a bicuspid (group 1, n = 44) or a tricuspid (group 2, n = 146) AV. Aortic wall specimen were examined with the "dissectometer" resulting in nine specific aortic-wall parameters derived from tensile strength curves (TSC). Results. Patients with a bicuspid AV showed significantly more calcified valves (43.2% versus 15.8%, P < 0.001), and a significantly thinner aortic wall (2.04 ± 0.42 mm versus 2.24 ± 0.41 mm, P = 0.008). Transesophageal echocardiography diameters (annulus, aortic sinuses, and sinotubular junction) were significantly larger in the bicuspid group (P = 0.003, P = 0.02, P = 0.01). We found no difference in the aortic wall cohesion between both groups as revealed by shear stress testing (P = 0.72, P = 0.40, P = 0.41). Conclusion. We observed no differences of TSC in patients presenting with tricuspid or bicuspid AVs. These results may allow us to assume that the morphology of the AV and the pathology of the ascending aorta are independent.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, West-German Heart Center, University Hospital Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany.
authors.forename: Jaroslav
authors.initials: J
authors.lastname: Benedik
authors.forename: Kevin
authors.initials: K
authors.lastname: Pilarczyk
authors.forename: Daniel
authors.initials: D
authors.lastname: Wendt
authors.forename: Jiri
authors.initials: J
authors.lastname: Indruch
authors.forename: Radek
authors.initials: R
authors.lastname: Flek
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Tsagakis
authors.forename: Savvas
authors.initials: S
authors.lastname: Alaeddine
authors.forename: Heinz
authors.initials: H
authors.lastname: Jakob