Key result
BAV-RL phenotype linked to ~3-fold higher ascending aorta dilation rates post-AVR vs BAV-AP.
Why the study?
Ascending aorta dilation after aortic valve replacement based on bicuspid aortic valve phenotypes within 12 months in patients with borderline aortic dilation had not been characterized.
Does the phenotype of bicuspid aortic valve (BAV-AP vs BAV-RL) affect ascending aorta dilation after aortic valve replacement in patients with borderline ascending aorta dilation?
Cohort (n=79)
Does the phenotype of bicuspid aortic valve (BAV-AP vs BAV-RL) affect ascending aorta dilation after aortic valve replacement in patients with borderline ascending aorta dilation?
Patients with bicuspid aortic valve and borderline ascending aorta dilation experience continued, albeit slow, aortic dilation after aortic valve replacement, with slightly faster enlargement observed in the BAV-RL phenotype.
Answers are grounded in this paper and cite their sources.
May warrant closer post-AVR aortic surveillance in BAV-RL; leaves open phenotype-specific thresholds.
Objective. To analyze ascending aorta dilation depending on phenotypes of bicuspid aortic valve (BAV) within 12 months after aortic valve replacement (AVR). Material and methods. A study with two parallel groups included 79 patients with BAV and dilation of the ascending aorta to 45—50 mm who underwent AVR between January 2018 and June 2022. The 1st group (BAV-AP) included 46 patients with anteroposterior orientation of leaflets (RL phenotype and true BAV), the 2nd group (BAV-RL) — 33 patients with right-left orientation of leaflets (RN phenotype, LN phenotype and true BAV with coronary arteries arising from different sinuses of Valsalva). In preoperative and follow-up period (12 months after surgery), all patients underwent transthoracic echocardiography to assess diameter of the ascending aorta. Results. In the 1st group, diameter of the ascending aorta increased in 13 (39.4%) patients by 0.72 mm (p=0.001) and by 0.39 mm in 6 (13.0%) patients in the 2nd group (p=0.013). There was no significant dilatation of sinuses of Valsalva in both groups. Conclusion. Ascending aorta dilation after AVR was observed in patients with BAV-AP and BAV-RL phenotypes. There was slightly faster enlargement of ascending aorta in many patients with BAV-RL phenotype.
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Filippov et al. (2025) conducted a cohort in Bicuspid aortic valve with borderline dilation of the ascending aorta (n=79). BAV-RL phenotype vs. BAV-AP phenotype was evaluated on Increase in diameter of the ascending aorta. The BAV-RL phenotype was associated with a higher rate of ascending aorta dilation 12 months after aortic valve replacement compared to the BAV-AP phenotype (39.4% vs 13.0%).
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