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Revista chilena de cardiología

On-line version ISSN 0718-8560

Abstract

DAYAN, Víctor et al. Aortic root dilatation in patients with Bicuspid aortic valve late after aortic valve replacement. Rev Chil Cardiol [online]. 2013, vol.32, n.2, pp.104-110. ISSN 0718-8560.  http://dx.doi.org/10.4067/S0718-85602013000200003.

Background: The presence of a bicuspid aorotic valve (BAV) is associated to aortic disease. Along their lifetime, BAV patients are highly likely to require surgery. Progression of aortic dilatation after aortic valve replacement (AVR) has not been definitely assessed. Methods: A total of 23 BAV patients with aortic diameter < 45mm were followed for a mean of 8 years after AVR. The aortic root and proximal ascending aorta were measured by echocardiografy 6 and again 8 years after surgery. Predictors for dilatation were estimated based on demographic data and pharmacologic treatment. Results: The aortic root diameter increased from 34.6±7.4 to 37.6±7.7 mm at 6 and 8 years post surgery, respectively (p=0.023). No change was observed at the tubular aorta . Mean progression of aortic root and tubular aorta during the 2-year interval was 2.9±4.7 mm and 0.4±5.8 mm respectively. Dilatation was seen mainly in smokers, those with a family history or dyslipidemia. Univariate predictors for aortic root dilatation were: family history of BAV or aortic pathology, prosthesis size and body surface area (BSA). Multivariate regression evidenced only BSA (beta coefficient 11.5) and family history (beta coefficient 4.5) as significant predictors. Conclusion: Aortic root continues to dilate after AVR in BAV patients. Higher BSA and family history of aortic pathology were found to be strong predictors of aortic root dilatation. These patients should be closely followed after AVR.

Keywords : Aortic root; Aortic valve; Aorta.

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