Bicuspid aortic valve patients undergoing aortic stenosis surgery required less concomitant coronary revascularization than those with tricuspid valves (OR for TAV 3.50; 95% CI 2.42-5.06; P<0.001).
Cohort (n=1,296)
No
Is bicuspid aortic valve morphology associated with a lower extent of coronary artery disease compared to tricuspid aortic valve in patients undergoing surgery for aortic stenosis?
Patients with bicuspid aortic valve stenosis have significantly less coronary artery disease and require fewer concomitant coronary revascularizations at the time of valve replacement compared to those with tricuspid aortic valves.
Effect estimate: OR 3.50 (95% CI 2.42-5.06)
p-value: p=<0.001
Background Bicuspid aortic valve (BAV) is the most common congenital cardiac malformation, which is often complicated by aortic valve stenosis (AoS). In tricuspid aortic valve (TAV), AoS strongly associates with coronary artery disease (CAD) with common pathophysiological factors. Yet, it remains unclear whether AoS in patients with BAV is also associated with CAD. This study investigated the association between the aortic valve morphological features and the extent of CAD. Methods and Results A single‐center study was performed, including all patients who underwent an aortic valve replacement attributable to AoS between 2006 and 2019. Coronary sclerosis was graded on preoperative coronary angiographies using the coronary artery greater even than scoring method, which divides the coronaries in 28 segments and scores nonobstructive (20%–49% sclerosis) and obstructive coronary sclerosis (>49% sclerosis) in each segment. Multivariate analyses were performed, controlling for age, sex, and CAD risk factors. A total of 1296 patients (931 TAV and 365 BAV) were included, resulting in 548 matched patients. Patients with TAV exhibited more CAD risk factors (odds ratio OR, 2.66; 95% CI, 1.79–3.96; P <0.001). Patients with BAV had lower coronary artery greater even than 20 (1.61±2.35 versus 3.60±2.79) and coronary artery greater even than 50 (1.24±2.43 versus 3.37±3.49) scores ( P <0.001), even after correcting for CAD risk factors ( P <0.001). Patients with TAV more often needed concomitant coronary revascularization (OR, 3.50; 95% CI, 2.42–5.06; P <0.001). Conclusions Patients with BAV who are undergoing surgery for AoS carry a lower cardiovascular risk profile, correlating with less coronary sclerosis and a lower incidence of concomitant coronary revascularization compared with patients with TAV.
Dolmaci et al. (Wed,) conducted a cohort in Aortic valve stenosis (n=1,296). Bicuspid aortic valve (BAV) vs. Tricuspid aortic valve (TAV) was evaluated on Concomitant coronary revascularization (OR 3.50, 95% CI 2.42-5.06, p=<0.001). Bicuspid aortic valve patients undergoing aortic stenosis surgery required less concomitant coronary revascularization than those with tricuspid valves (OR for TAV 3.50; 95% CI 2.42-5.06; P<0.001).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: