Key result
Bicuspid aortic valve patients had a significantly higher rate of continued ascending aorta dilatation after aortic valve replacement compared to tricuspid aortic valve patients (p<0.05).
Why the study?
The study was conducted to evaluate the mid-term outcomes of aortic valve replacement for bicuspid versus tricuspid aortic valves and to identify related risk factors.
Does aortic valve replacement in bicuspid aortic valve patients lead to different rates of ascending aorta dilation compared to tricuspid aortic valve patients?
Cohort (n=160)
No
Does aortic valve replacement in bicuspid aortic valve patients lead to different rates of ascending aorta dilation compared to tricuspid aortic valve patients?
p-value: p=<0.05
Following aortic valve replacement, patients with bicuspid aortic valves are at higher risk for continued ascending aorta dilation compared to those with tricuspid aortic valves, particularly those with type 1 morphology, age ≥ 40, or aortic regurgitation.
OBJECTIVE: The purpose of this study was to evaluate the mid-term outcome of aortic valve replacement for bicuspid aortic valve and tricuspid aortic valve and the related risk factors. METHODS: From January 2014 to June 2019, 177 tricuspid aortic valve patients and 101 bicuspid aortic valve patients who underwent aortic valve replacement in our hospital were collected. 1:1 propensity score matching analysis was used to control the bias in patient selection. The perioperative and follow-up data between the two groups were compared. Independent risk factors which were associated with the continued dilatation of the ascending aorta were identified by univariate or multivariate logistic regression analysis. RESULTS: After the matching procedure, 160 patients were included in the analysis (80 in each group). Baseline characteristics, intraoperative, and perioperative outcomes were similar between the two groups (all p > 0.05). Moreover, 67 patients in the tricuspid aortic valve group and 70 in the bicuspid aortic valve group completed the follow-up. The ascending aorta change, annual change rate, and the proportion of continuous dilation of ascending aorta in bicuspid aortic valve group were significantly higher than those in the tricuspid aortic valve group (p < 0.05). Multivariate logistic regression analysis showed that type 1 in bicuspid aortic valve (OR 5.173; 95% CI 1.772, 15.101; p = 0.003), aortic regurgitation (OR 3.673; 95% CI 1.133, 11.908; p = 0.030), and aortic valve stenosis with regurgitation (OR 6.489; 95% CI 1.726, 24.404; p = 0.006) were independent risk factors for the continued dilatation of the ascending aorta in all AV patients. Furthermore, the multivariate logistic regression analysis showed that type 1 in bicuspid aortic valve (OR 5.157; 95% CI 1.053, 25.272; p = 0.043), age ≥ 40 years (OR 6.956; 95% CI 1.228, 39.410; p = 0.028), and aortic regurgitation (OR 4.322; 95% CI 1.174, 15.911; p = 0.028) were independent risk factors for the continued dilatation of the ascending aorta in bicuspid aortic valve patients. CONCLUSION: Compared with tricuspid aortic valve patients, the ascending aorta of bicuspid aortic valve patients is more likely to continue to enlarge after aortic valve replacement. Type 1 in bicuspid aortic valve, age ≥ 40 years, and aortic regurgitation were the independent risk factors.
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Liu et al. (2021) conducted a cohort in Bicuspid and tricuspid aortic valve disease requiring aortic valve replacement (n=160). Bicuspid aortic valve vs. Tricuspid aortic valve was evaluated on Continued dilatation of the ascending aorta (p=<0.05). Bicuspid aortic valve patients had a significantly higher rate of continued ascending aorta dilatation after aortic valve replacement compared to tricuspid aortic valve patients (p<0.05).
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