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The significance of bicuspid aortic valve after surgery for acute type A aortic dissection

Mennander, Ari ; Olsson, Christian ; Jeppsson, Anders ; Geirsson, Arnar ; Hjortdal, Vibeke ; Hansson, Emma C ; Jarvela, Kati ; Nozohoor, Shahab LU ; Gunn, Jarmo and Ahlsson, Anders , et al. (2020) In The Journal of thoracic and cardiovascular surgery 159(3). p.3-767
Abstract

OBJECTIVE: Decision-making concerning the extent of the repair of acute type A aortic dissection (ATAAD) includes functional and anatomical assessment of the aortic valve. We hypothesized that bicuspid aortic valve (BAV) does not impact outcome after surgery for ATAAD. We therefore evaluated the outcome after ATAAD surgery in relation to the presence of BAV, acute aortic regurgitation (AR), and surgical approach, using the Nordic Consortium for Acute Type A Aortic Dissection database.

METHODS: Eight participating Nordic centers collected data from 1122 patients undergoing ATAAD surgery during the years 2005 to 2014. Early complications, reoperations and survival were compared between patients with BAV and tricuspid aortic valves... (More)

OBJECTIVE: Decision-making concerning the extent of the repair of acute type A aortic dissection (ATAAD) includes functional and anatomical assessment of the aortic valve. We hypothesized that bicuspid aortic valve (BAV) does not impact outcome after surgery for ATAAD. We therefore evaluated the outcome after ATAAD surgery in relation to the presence of BAV, acute aortic regurgitation (AR), and surgical approach, using the Nordic Consortium for Acute Type A Aortic Dissection database.

METHODS: Eight participating Nordic centers collected data from 1122 patients undergoing ATAAD surgery during the years 2005 to 2014. Early complications, reoperations and survival were compared between patients with BAV and tricuspid aortic valves (TAV) before and after propensity score matching for sex, age, AR, organ malperfusion, hemodynamic instability, and site of the tear. Mean follow-up (range) for patients with TAV and BAV was 3.1 years (0-10.4 years) and 3.2 years (0-9.0 years), respectively.

RESULTS: Altogether, 65 (5.8%) of the patients had BAV. Root replacement was more frequently performed in the BAV as compared with the TAV group (60% vs 23%, P < .001). Survival, however, did not differ significantly between patients with BAV or TAV, either before (P = .230) or after propensity score-matching (P = .812). Even so, in cohort as a whole, patients presenting with AR had less favorable survival.

CONCLUSIONS: Early and mid-term survival did not differ significantly between patients with BAV and TAV.

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published
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The Journal of thoracic and cardiovascular surgery
volume
159
issue
3
pages
3 - 767
publisher
Mosby
external identifiers
  • scopus:85064312162
  • pmid:31005301
ISSN
1097-685X
DOI
10.1016/j.jtcvs.2019.03.012
language
English
LU publication?
yes
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Copyright © 2019 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.
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5dcf83cc-5fcc-4d54-84cd-318fa29b264b
date added to LUP
2019-05-22 09:09:39
date last changed
2020-07-08 04:52:50
@article{5dcf83cc-5fcc-4d54-84cd-318fa29b264b,
  abstract     = {<p>OBJECTIVE: Decision-making concerning the extent of the repair of acute type A aortic dissection (ATAAD) includes functional and anatomical assessment of the aortic valve. We hypothesized that bicuspid aortic valve (BAV) does not impact outcome after surgery for ATAAD. We therefore evaluated the outcome after ATAAD surgery in relation to the presence of BAV, acute aortic regurgitation (AR), and surgical approach, using the Nordic Consortium for Acute Type A Aortic Dissection database.</p><p>METHODS: Eight participating Nordic centers collected data from 1122 patients undergoing ATAAD surgery during the years 2005 to 2014. Early complications, reoperations and survival were compared between patients with BAV and tricuspid aortic valves (TAV) before and after propensity score matching for sex, age, AR, organ malperfusion, hemodynamic instability, and site of the tear. Mean follow-up (range) for patients with TAV and BAV was 3.1 years (0-10.4 years) and 3.2 years (0-9.0 years), respectively.</p><p>RESULTS: Altogether, 65 (5.8%) of the patients had BAV. Root replacement was more frequently performed in the BAV as compared with the TAV group (60% vs 23%, P &lt; .001). Survival, however, did not differ significantly between patients with BAV or TAV, either before (P = .230) or after propensity score-matching (P = .812). Even so, in cohort as a whole, patients presenting with AR had less favorable survival.</p><p>CONCLUSIONS: Early and mid-term survival did not differ significantly between patients with BAV and TAV.</p>},
  author       = {Mennander, Ari and Olsson, Christian and Jeppsson, Anders and Geirsson, Arnar and Hjortdal, Vibeke and Hansson, Emma C and Jarvela, Kati and Nozohoor, Shahab and Gunn, Jarmo and Ahlsson, Anders and Gudbjartsson, Tomas},
  issn         = {1097-685X},
  language     = {eng},
  number       = {3},
  pages        = {3--767},
  publisher    = {Mosby},
  series       = {The Journal of thoracic and cardiovascular surgery},
  title        = {The significance of bicuspid aortic valve after surgery for acute type A aortic dissection},
  url          = {http://dx.doi.org/10.1016/j.jtcvs.2019.03.012},
  doi          = {10.1016/j.jtcvs.2019.03.012},
  volume       = {159},
  year         = {2020},
}