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General Thoracic and Cardiovascular Surgery

Published in:

01-05-2017 | Original Article

Late post-AVR progression of bicuspid aortopathy: link to hemodynamics

Authors: Shiho Naito, Tatiana Gross, Kushtrim Disha, Yskert von Kodolitsch, Hermann Reichenspurner, Evaldas Girdauskas

Published in: General Thoracic and Cardiovascular Surgery | Issue 5/2017

Abstract

Background and aim of the study

The ascending aortic dilatation may progress after aortic valve replacement (AVR) in bicuspid aortic valve (BAV) patients. Our aim was to evaluate rheological flow patterns and histological characteristics of the aneurysmal aorta in BAV patients at the time of reoperative aortic surgery.

Materials and Methods

13 patients (mean age: 42 ± 9 years, 10 (77%) male) with significant progression of proximal aortopathy after isolated AVR surgery for BAV disease (i.e., 16.7 ± 8.1 years post-AVR) were identified by cardiac phase-contrast cine magnetic resonance imaging (MRI) in our hospital. A total of nine patients (69%) underwent redo aortic surgery. Based on the MRI data, the aortic area of the maximal flow-induced stress (jet sample) and the opposite site (control sample) were identified and corresponding samples were collected intraoperatively. Histological sum-score values [i.e. aortic wall changes were graded based on a summation of seven histological criteria (each scored from 0 to 3)] were compared between these samples.

Results

Mean proximal aortic diameter at MRI follow-up was 55 ± 6 mm (range 47–66mm). Preoperative cardiac MRI demonstrated eccentric systolic flow pattern directed towards right-lateral/right posterior wall of the proximal aorta in 9/13 (69%) patients. Histological sum-score values were significantly higher in the jet sample vs control sample (i.e., 8.3 ± 3.8 vs 5.6 ± 2.4, respectively, p = 0.04).

Conclusions

Hemodynamic factors may still be involved in the late progression of bicuspid aortopathy even after isolated AVR surgery for BAV disease.

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Title: Late post-AVR progression of bicuspid aortopathy: link to hemodynamics
Authors: Shiho Naito
Tatiana Gross
Kushtrim Disha
Yskert von Kodolitsch
Hermann Reichenspurner
Evaldas Girdauskas
Publication date: 01-05-2017
Publisher: Springer Japan
Published in: General Thoracic and Cardiovascular Surgery / Issue 5/2017
Print ISSN: 1863-6705
Electronic ISSN: 1863-6713
DOI: https://doi.org/10.1007/s11748-017-0746-4

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Late post-AVR progression of bicuspid aortopathy: link to hemodynamics

Abstract

Background and aim of the study

Materials and Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background and aim of the study

Materials and Methods

Results

Conclusions

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