Why the study?
Bicuspid aortic valve is commonly associated with complications such as aortic stenosis, aortic insufficiency, and ascending aortic aneurysm, requiring evaluation of surgical approaches to ascending aorta pathology.
Does reduction ascending aortoplasty compared to ascending aorta replacement prevent aortic redilatation over time in patients with bicuspid aortic valve and ascending aortic aneurysm undergoing aortic valve replacement?
Cohort (n=105)
No
Does reduction ascending aortoplasty compared to ascending aorta replacement prevent aortic redilatation over time in patients with bicuspid aortic valve and ascending aortic aneurysm undergoing aortic valve replacement?
Absolute Event Rate: 57.1% vs 0%
In patients with bicuspid aortic valve and ascending aortic aneurysm, reduction ascending aortoplasty is associated with aortic redilatation over time compared to ascending aorta replacement.
Aortoplasty was associated with redilatation; warrants caution and leaves open need for randomized comparison in bicuspid aortopathy.
Bicuspid aortic valve (BAV) is the most common heart valve malformation, and it may be associated with the development of long-term complications, such as aortic stenosis (AS) secondary to valvular calcification and aortic insufficiency (AI), with or without ascending aortic aneurysm (AAA). This study was performed at the Institute of Cardiovascular Diseases, Timişoara, Romania, from 2015 through 2018 and included a total of 105 patients with BAV. Out of the 105 BAV patients, 14 displayed AAA, alongside either AS or AI, and were selected undergo aortic valve replacement (AVR) alongside surgical replacement or aortoplasty of the ascending aorta, and the elastic fiber loss in the ascending aortic wall was evaluated for each patient. Two surgical interventions used alongside AVR in BAV patients with AAA and AS or AI were compared in this study: reduction ascending aortoplasty (RAA) and ascending aorta replacement (AAR). Postoperative follow-ups have shown RAA is useful short-term but that, in contrast to AAR, it leads to aortic redilatation over time. These results can contribute to a major future meta-analysis with the goal of improving the current clinical practice guidelines for BAV aortopathy.
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Dima et al. (2021) conducted a cohort in Bicuspid aortic valve aortopathy (n=105). Reduction ascending aortoplasty (RAA) vs. Ascending aorta replacement (AAR) was evaluated on Aortic redilatation at 3 years.
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