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Published in: Surgery Today 8/2014

01-08-2014 | Original Article

Factors affecting a dilated ascending aorta in patients with bicuspid aortic valve: the relevance of valve anatomy, body size and age

Authors: Hiroyuki Nishi, Taichi Sakaguchi, Shigeru Miyagawa, Yasushi Yoshikawa, Satsuki Fukushima, Daisuke Yoshioka, Takayoshi Ueno, Toru Kuratani, Yoshiki Sawa

Published in: Surgery Today | Issue 8/2014

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Abstract

Purpose

Information regarding the appropriate management of patients with moderately dilated ascending aortas is limited. We investigated factors affecting ascending aortic dilatation in BAV patients, such as anatomy, body size and age.

Methods

We evaluated 130 patients with BAV (age, 59.9 ± 16.1 years; body surface area (BSA), 1.58 ± 0.20 m2) who underwent aortic valve surgery. The cusp configuration was determined according to the presence and location of the raphe and the cusp direction. The ascending aortic diameter index (AADI) was calculated using computed tomography and the BSA.

Results

Sixty-four patients had A-P-type BAV, while 66 had R-L-type BAV. The mean ascending aorta diameter was 42.6 ± 6.7 mm, and the mean AADI was 27.1 ± 5.6 mm/m2. Based on the AADI, cusp configuration (R-L-BAV: 28.3 ± 6.0 mm/m2 vs. A-P-BAV: 25.8 ± 4.9 mm/m2, P < 0.05), a female gender, age and the presence of aortic stenosis were found to be related to ascending aortic dilatation, while the mean ascending aortic diameter did not differ between the groups. Among the elderly patients, an AADI greater than 28 mm/m2 was more frequently observed in the R-L-BAV group than in the A-P-BAV group. Ascending aortic replacement was required after 10 years in two patients with R-L-BAV and no patients with A-P-BAV.

Conclusions

The relative ascending aortic diameter helped to identify patients with BAV with a risk of dilatation, indicating that the use of ascending aortic replacement should be considered more frequently in patients with R-L-type BAV, while the procedure is avoidable in elderly patients with A-P-type BAV.
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Metadata
Title
Factors affecting a dilated ascending aorta in patients with bicuspid aortic valve: the relevance of valve anatomy, body size and age
Authors
Hiroyuki Nishi
Taichi Sakaguchi
Shigeru Miyagawa
Yasushi Yoshikawa
Satsuki Fukushima
Daisuke Yoshioka
Takayoshi Ueno
Toru Kuratani
Yoshiki Sawa
Publication date
01-08-2014
Publisher
Springer Japan
Published in
Surgery Today / Issue 8/2014
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-013-0798-8

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