Key result
Bicuspid aortic valve was associated with similar 10-year freedom from adverse aortic events compared to tricuspid aortic valve after isolated aortic valve replacement (98.1% vs 95.0%; P=0.636).
Why the study?
It was unclear how long-term outcomes for ascending aortic dilatation and adverse aortic events differ between patients with BAV and TAV after isolated aortic valve replacement.
Does bicuspid aortic valve compared to tricuspid aortic valve affect ascending aortic dilatation and adverse aortic events in patients undergoing isolated aortic valve replacement?
Cohort (n=310)
Does bicuspid aortic valve compared to tricuspid aortic valve affect ascending aortic dilatation and adverse aortic events in patients undergoing isolated aortic valve replacement?
Absolute Event Rate: 98.1% vs 95%
p-value: p=0.636
Bicuspid aortic valve is not associated with an increased risk of adverse aortic events or faster ascending aortic dilatation compared to tricuspid aortic valve after isolated aortic valve replacement.
Supports comparable aortic safety post-isolated AVR regardless of valve morphology; hypothesis-generating and should not yet change practice.
OBJECTIVES: The aims of the present study were to compare the long-term outcomes for ascending aortic dilatation and adverse aortic events after isolated aortic valve replacement between patients with bicuspid aortic valve (BAV) and tricuspid aortic valve ( TAV). METHODS: This retrospective study included 310 patients who had undergone isolated aortic valve replacement with an ascending aorta diameter ≤ 45 mm between January 2010 and September 2021. The patients were divided into BAV group (n=90) and TAV group (n=220). The differences in the dilation rate of the ascending aorta and long-term outcomes were analyzed. RESULTS: Overall survival was 89 ± 4% in the BAV group vs. 75 ± 6% in the TAV group at 10 years postoperatively (P=0.007), yet this difference disappeared after adjusting exclusively for age (P=0.343). The mean annual growth rate of the ascending aorta was similar between the two groups during follow-up (0.5 ± 0.6 mm/year vs. 0.4 ± 0.5 mm/year; P=0.498). Ten-year freedom from adverse aortic events was 98.1% in the BAV group vs. 95.0% in the TAV group (P=0.636). Multivariable analysis revealed preoperative ascending aorta diameter to be a significant predictor of adverse aortic events (hazard ratio: 1.76; 95% confidence interval: 1.33 to 2.38; P<0.001). CONCLUSION: Our study revealed that the long-term survival and the risks of adverse aortic events between BAV and TAV patients were similar after isolated aortic valve replacement. BAV was not a risk factor of adverse aortic events.
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Zheng et al. (2024) conducted a cohort in Isolated aortic valve replacement (n=310). Bicuspid aortic valve (BAV) vs. Tricuspid aortic valve (TAV) was evaluated on Ten-year freedom from adverse aortic events (p=0.636). Bicuspid aortic valve was associated with similar 10-year freedom from adverse aortic events compared to tricuspid aortic valve after isolated aortic valve replacement (98.1% vs 95.0%; P=0.636).
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