| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
J Thorac Cardiovasc Surg 2004;128:677-683
© 2004 The American Association for Thoracic Surgery
Surgery for Acquired Cardiovascular Disease |
a Division of Cardiovascular Surgery, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
b Department of Surgery, University of Toronto, Toronto, Ontario, Canada
Read at the Eighty-fourth Annual Meeting of The American Association for Thoracic Surgery, Toronto, Ontario, Canada, April 25-28, 2004.
Received for publication April 23, 2004; revisions received June 12, 2004; accepted for publication July 2, 2004. * Address for reprints: Michael A. Borger, MD, PhD, Division of Cardiovascular Surgery, Toronto General Hospital, Room EN 13-217, 200 Elizabeth St, Toronto, Ontario, Canada M5G 2C4 (E-mail: michael.borger{at}uhn.on.ca).
OBJECTIVE: The optimal diameter at which replacement of the ascending aorta should be performed in patients with bicuspid aortic valve disease is not known.
METHODS: We reviewed all patients with bicuspid aortic valves undergoing aortic valve replacement at our institution from 1979 through 1993 (n = 201). Patients undergoing concomitant replacement of the ascending aorta were excluded.
RESULTS: Follow-up was obtained on 98% of patients and was 10.3 ± 3.8 (mean ± SD) years. The average patient age was 56 ± 15 years, and 76% were male. The ascending aorta was normal (<4.0 cm) in 115 (57%) patients, mildly dilated (4.0-4.4 cm) in 64 (32%) patients, and moderately dilated (4.5-4.9 cm) in 22 (11%) patients. All patients with bicuspid aortic valves with marked dilation (>5.0 cm) underwent replacement of the ascending aorta and were therefore excluded. Fifteen-year survival was 67%. During follow-up, 44 patients required reoperation, predominantly for aortic valve prosthesis failure. Twenty-two patients had long-term complications related to the ascending aorta: 18 required an operative procedure to replace the ascending aorta (for aortic aneurysm), 1 had aortic dissection, and 3 experienced sudden cardiac death. Fifteen-year freedom from ascending aorta–related complications was 86%, 81%, and 43% in patients with an aortic diameter of less than 4.0 cm, 4.0 to 4.4 cm, and 4.5 to 4.9 cm, respectively (P< .001).
CONCLUSIONS: Patients undergoing operations for bicuspid aortic valve disease should be considered for concomitant replacement of the ascending aorta if the diameter is 4.5 cm or greater.
This article has been cited by other articles:
|
|
 |
|
  2006 WRITING COMMITTEE MEMBERS, R. O. Bonow, B. A. Carabello, K. Chatterjee, A. C. de Leon Jr, D. P. Faxon, M. D. Freed, W. H. Gaasch, B. W. Lytle, R. A. Nishimura, et al. 2008 Focused Update Incorporated Into the ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): Endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons Circulation, October 7, 2008; 118(15): e523 - e661. [Full Text] [PDF]
|
|
|
|
 |
|
 C. F. Russo, A. Cannata, M. Lanfranconi, E. Vitali, A. Garatti, and E. Bonacina Is aortic wall degeneration related to bicuspid aortic valve anatomy in patients with valvular disease? J. Thorac. Cardiovasc. Surg., October 1, 2008; 136(4): 937 - 942. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. O. Bonow, B. A. Carabello, K. Chatterjee, A. C. de Leon Jr, D. P. Faxon, M. D. Freed, W. H. Gaasch, B. W. Lytle, R. A. Nishimura, P. T. O'Gara, et al. 2008 Focused Update Incorporated Into the ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease) Endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons J. Am. Coll. Cardiol., September 23, 2008; 52(13): e1 - e142. [Full Text] [PDF]
|
|
|
|
|
|
G. B. Pettersson, A. C. Crucean, R. Savage, C. M. Halley, R. A. Grimm, L. G. Svensson, S. Naficy, A. M. Gillinov, J. Feng, and E. H. Blackstone Toward predictable repair of regurgitant aortic valves a systematic morphology-directed approach to bicommissural repair. J. Am. Coll. Cardiol., July 1, 2008; 52(1): 40 - 49. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Doss, S. Sirat, P. Risteski, S. Martens, and A. Moritz Pericardial patch augmentation for repair of incompetent bicuspid aortic valves at midterm Eur. J. Cardiothorac. Surg., May 1, 2008; 33(5): 881 - 884. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. S. Fazel, H. R. Mallidi, R. S. Lee, M. P. Sheehan, D. Liang, D. Fleischman, R. Herfkens, R. S. Mitchell, and D. C. Miller The aortopathy of bicuspid aortic valve disease has distinctive patterns and usually involves the transverse aortic arch. J. Thorac. Cardiovasc. Surg., April 1, 2008; 135(4): 901 - 907.e2. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M J Collins, V Dev, B H Strauss, P W M Fedak, and J Butany Variation in the histopathological features of patients with ascending aortic aneurysms: a study of 111 surgically excised cases J. Clin. Pathol., April 1, 2008; 61(4): 519 - 523. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M J Collins, J Butany, M A Borger, B H Strauss, and T E David Implications of a congenitally abnormal valve: a study of 1025 consecutively excised aortic valves J. Clin. Pathol., April 1, 2008; 61(4): 530 - 536. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. F. Rhodes, Z. M. Hijazi, and R. J. Sommer Pathophysiology of Congenital Heart Disease in the Adult, Part II: Simple Obstructive Lesions Circulation, March 4, 2008; 117(9): 1228 - 1237. [Full Text] [PDF]
|
|
|
|
 |
|
 Z. Masuda, T. Murakami, E. Shishido, and M. Kuinose A Rare Cause of Dissection of Ascending Aorta after Aortic Valve Replacement Asian Cardiovasc Thorac Ann, February 1, 2008; 16(1): e4 - e6. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Della Corte, C. Quarto, C. Bancone, C. Castaldo, F. Di Meglio, D. Nurzynska, L. S. De Santo, M. De Feo, M. Scardone, S. Montagnani, et al. Spatiotemporal patterns of smooth muscle cell changes in ascending aortic dilatation with bicuspid and tricuspid aortic valve stenosis: Focus on cell matrix signaling J. Thorac. Cardiovasc. Surg., January 1, 2008; 135(1): 8 - 18. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. R. Brinster, R. J. Rizzo, and R. M. Bolman III Ascending Aortic Aneurysms Card. Surg. Adult, January 1, 2008; 3(2008): 1223 - 1250. [Full Text]
|
|
|
|
|
|
L. A. Matura, V. B. Ho, D. R. Rosing, and C. A. Bondy Aortic Dilatation and Dissection in Turner Syndrome Circulation, October 9, 2007; 116(15): 1663 - 1670. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. D. Etz, T. M. Homann, D. Silovitz, D. Spielvogel, C. A. Bodian, M. Luehr, G. DiLuozzo, K. A. Plestis, and R. B. Griepp Long-Term Survival After the Bentall Procedure in 206 Patients With Bicuspid Aortic Valve Ann. Thorac. Surg., October 1, 2007; 84(4): 1186 - 1194. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. A. Pape, T. T. Tsai, E. M. Isselbacher, J. K. Oh, P. T. O'Gara, A. Evangelista, R. Fattori, G. Meinhardt, S. Trimarchi, E. Bossone, et al. Aortic Diameter >=5.5 cm Is Not a Good Predictor of Type A Aortic Dissection: Observations From the International Registry of Acute Aortic Dissection (IRAD) Circulation, September 4, 2007; 116(10): 1120 - 1127. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. B. Reece, R. R. Singh, B. M. Stiles, B. B. Peeler, J. A. Kern, C. G. Tribble, and I. L. Kron Replacement of the Proximal Aorta Adds No Further Risk to Aortic Valve Procedures Ann. Thorac. Surg., August 1, 2007; 84(2): 473 - 478. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. A. Borger, A. F. Nette, M. Maganti, and C. M. Feindel Carpentier-Edwards Perimount Magna Valve Versus Medtronic Hancock II: A Matched Hemodynamic Comparison Ann. Thorac. Surg., June 1, 2007; 83(6): 2054 - 2058. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Matt, A. von Orelli, F. Bernet, T. Grussenmeyer, I. Lefkovits, and H.-R. Zerkowski Proteomics of Ascending Aortic Aneurysm with Bicuspid or Tricuspid Aortic Valve Asian Cardiovasc Thorac Ann, June 1, 2007; 15(3): 185 - 190. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. R. Davies, R. K. Kaple, D. Mandapati, A. Gallo, D. M. Botta Jr, J. A. Elefteriades, and M. A. Coady Natural History of Ascending Aortic Aneurysms in the Setting of an Unreplaced Bicuspid Aortic Valve Ann. Thorac. Surg., April 1, 2007; 83(4): 1338 - 1344. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Goland, L. S.C. Czer, M. A. De Robertis, J. Mirocha, R. M. Kass, G. P. Fontana, W. Chang, and A. Trento Risk Factors Associated With Reoperation and Mortality in 252 Patients After Aortic Valve Replacement for Congenitally Bicuspid Aortic Valve Disease Ann. Thorac. Surg., March 1, 2007; 83(3): 931 - 937. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Della Corte, C. Bancone, C. Quarto, G. Dialetto, F. E. Covino, M. Scardone, G. Caianiello, and M. Cotrufo Predictors of ascending aortic dilatation with bicuspid aortic valve: a wide spectrum of disease expression Eur. J. Cardiothorac. Surg., March 1, 2007; 31(3): 397 - 405. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H.-J. Schafers, D. Aicher, F. Langer, and H. F. Lausberg Preservation of the Bicuspid Aortic Valve Ann. Thorac. Surg., February 1, 2007; 83(2): S740 - S745. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Authors/Task Force Members, A. Vahanian, H. Baumgartner, J. Bax, E. Butchart, R. Dion, G. Filippatos, F. Flachskampf, R. Hall, B. Iung, et al. Guidelines on the management of valvular heart disease: The Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology Eur. Heart J., January 26, 2007; (2007) ehl428v1. [Full Text] [PDF]
|
|
|
|
|
|
J. Aboulhosn and J. S. Child Left Ventricular Outflow Obstruction: Subaortic Stenosis, Bicuspid Aortic Valve, Supravalvar Aortic Stenosis, and Coarctation of the Aorta Circulation, November 28, 2006; 114(22): 2412 - 2422. [Full Text] [PDF]
|
|
|
|
|
|
L. N. Girardi, K. H. Krieger, C. A. Mack, L. Y. Lee, A. J. Tortolani, and O. W. Isom Reoperations on the ascending aorta and aortic root in patients with previous cardiac surgery. Ann. Thorac. Surg., October 1, 2006; 82(4): 1407 - 1412. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. O. Bonow, B. A. Carabello, K. Chatterjee, A. C. de Leon Jr, D. P. Faxon, M. D. Freed, W. H. Gaasch, B. W. Lytle, R. A. Nishimura, P. T. O'Gara, et al. ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease) Developed in Collaboration With the Society of Cardiovascular Anesthesiologists Endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons J. Am. Coll. Cardiol., August 1, 2006; 48(3): e1 - e148. [Full Text] [PDF]
|
|
|
|
|
|
R. O. Bonow, B. A. Carabello, K. Chatterjee, A. C. de Leon Jr, D. P. Faxon, M. D. Freed, W. H. Gaasch, B. W. Lytle, R. A. Nishimura, P. T. O'Gara, et al. ACC/AHA 2006 Practice Guidelines for the Management of Patients With Valvular Heart Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease) Developed in Collaboration With the Society of Cardiovascular Anesthesiologists Endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons J. Am. Coll. Cardiol., August 1, 2006; 48(3): 598 - 675. [Full Text] [PDF]
|
|
|
|
|
|
M. A. Borger, S. M. Carson, J. Ivanov, V. Rao, H. E. Scully, C. M. Feindel, and T. E. David Stentless Aortic Valves are Hemodynamically Superior to Stented Valves During Mid-Term Follow-Up: A Large Retrospective Study Ann. Thorac. Surg., December 1, 2005; 80(6): 2180 - 2185. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. B. Luciani, A. Favaro, G. Casali, F. Santini, and A. Mazzucco Ross Operation in the Young: A Ten-Year Experience Ann. Thorac. Surg., December 1, 2005; 80(6): 2271 - 2277. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
