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  • Title: Outcomes After Isolated Aortic Valve Replacement in Patients with Bicuspid vs Tricuspid Aortic Valve.
    Author: Sun J, Chen S, Sun C, Qi H, Qian X, Zheng Z.
    Journal: Semin Thorac Cardiovasc Surg; 2022; 34(3):854-865. PubMed ID: 34380080.
    Abstract:
    To compare the outcomes in patients undergoing isolated aortic valve replacement with bicuspid (BAV) vs tricuspid aortic valves (TAV). A total of 1204 consecutive patients (BAV, n = 454; TAV, n = 750) underwent isolated aortic valve replacement (AVR) between 2002 and 2009 at a single institution. Adverse aortic events were defined as the occurrence of aortic dissection or the ascending aorta diameter greater than 50 mm or sudden death during follow-up. Propensity score matching yielded 318 patient pairs. Follow-up was obtained on 1156 patients. The mean length of follow up was 10.4 ± 3.9 years. A total of 155 (13.4%) patients died, and adverse aortic events occurred in 44 (3.8%) patients. After propensity score matching, the 12-year survivals was 85.5% in the BAV group and 89.2% in the TAV group; hazard ratio (HR) 1.6; 95% confidence interval (CI) 1.0-2.5; P = 0.057. The 12-year cumulative incidence of late adverse aortic events was 14.6% in the BAV group and 10.8% in the TAV group; subdistribution hazard ratio (sHR) 1.1; 95% CI 0.6-2.0; P = 0.758. In the isolated aortic regurgitation subgroup, the rate of adverse aortic events was significantly higher in the BAV group than in the TAV group (sHR, 2.1; 95% CI, 1.1-4.0; P = 0.021). The long-term survival after isolated AVR was similar in both BAV and TAV patients. BAV does not increase the adverse aortic events after isolated AVR compared with the TAV.
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