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March 1, 2017The Journal of Cardiovascular Surgery

Mitral regurgitation after previous aortic valve surgery for bicuspid aortic valve insufficiency

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Why the study?

Does isolated aortic valve replacement compared to aortic root replacement increase the risk of new-onset mitral regurgitation in patients with bicuspid aortic valve regurgitation and aortic root dilatation?

Population

97 consecutive patients with bicuspid aortic valve regurgitation, aortic root diameter >40 mm, no relevant…

Comparison

Isolated aortic valve replacement (AVR) vs Aortic root replacement with a composite graft…

Design

Cohort

Follow-up

mean 10.4±4.0 years

Authors

EGEvaldas GirdauskasCardiac SurgeryKDKushtrim DishaZentralklinik Bad BerkaAEAndres Espinoza

Discussion

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Implication

Isolated AVR was associated with higher late MR risk than root replacement in BAV regurgitation; leaves open optimal root management strategy.

Structured PICO

Does isolated aortic valve replacement compared to aortic root replacement increase the risk of new-onset mitral regurgitation in patients with bicuspid aortic valve regurgitation and aortic root dilatation?

P
Population
97 consecutive patients (mean age 47±11 years, 94% men) with bicuspid aortic valve (BAV) regurgitation, aortic root diameter >40 mm, no relevant mitral valve disease (MR<2+), and no simultaneous mitral intervention at the time of BAV surgery.
I
Intervention
Isolated aortic valve replacement (AVR)
C
Comparator
Aortic root replacement with a composite graft (ARR) for root aneurysm >50 mm
O
Outcome
Freedom from new-onset MR>2+ and redo mitral valve surgerycomposite

In patients with bicuspid aortic valve regurgitation and root dilatation, isolated aortic valve replacement is associated with a higher risk of late new-onset mitral regurgitation compared to aortic root replacement.

Cite This Study

Girdauskas et al. (2017) studied this question.

synapsesocial.com/papers/6a7022fbabc331a858079573https://doi.org/10.23736/s0021-9509.16.09311-3

Topics

Mitral valve interventionValvular heart disease
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Aortic root dilatation in young men with normally functioning bicuspid aortic valves1999 · 467 citations
  2. 2New insights into bicuspid aortic valve disease: the elongated anterior mitral leaflet2012 · 18 citations
  3. 3Bicuspid Aortic Valves Are Associated With Aortic Dilatation Out of Proportion to Coexistent Valvular Lesions2000 · 373 citations
  4. 4Predictors of ascending aortic dilatation with bicuspid aortic valve: a wide spectrum of disease expression☆2007 · 339 citations
  5. 5The bicuspid aortic valve: an integrated phenotypic classification of leaflet morphology and aortic root shape2008 · 440 citations