[A retrospective comparative study of acute type A aortic dissection in patients with Marfan syndrome and bicuspid aortic valves].
OBJECTIVE
To compare the clinical features of type A aortic dissection (AAD) in patients with Marfan syndrome (MFS) and bicuspid aortic valves (BAV).


METHODS
Data from patients undergoing surgery for acute AAD between April 2008 and April 2012 at our institute were retrospectively collected. Patients were categorized into MFS group (n = 39) and BAV group (n = 28) to investigate their clinical and prognostic features.


RESULTS
Patients in MFS and BAV groups always experienced the sudden onset of chest pain. MFS patients tended to have younger age [(35 ± 8) y vs (47 ± 13) y, P < 0.001], wider aortic sinus [(55.4 ± 9.8) mm vs (42.6 ± 8.6) mm, P < 0.01] and higher rate of moderate-to-severe aortic regurgitation (69.2% vs 32.1%, P = 0.003). Patients in BAV group were featured with higher rate of moderate-to-severe aortic stenosis. Though the operation procedures were similar in both groups, the 30-day postoperative mortality was significantly higher among BAV patients (25.0% vs 5.1%, P = 0.020).


CONCLUSIONS
MFS and BAV represent unique subgroups of acute type A aortic dissection. BAV-associated dissection demonstrated strikingly higher postoperative mortality in our study population.
Department of Echocardiography, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Yongshi
Y
Wang
Lili
L
Dong
Haohua
H
Yao
Chunsheng
C
Wang
Email: shu.xianhong@zs-hospital.sh.cn.
Xianhong
X
Shu
D000293:Adolescent; D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D001021:Aortic Valve / Q000002:abnormalities* / Q000601:surgery; D000082882:Bicuspid Aortic Valve Disease; D005260:Female; D006349:Heart Valve Diseases / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D008297:Male; D008382:Marfan Syndrome / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult