Distal aortic progression following acute type A aortic dissection repair among patients with bicuspid and tricuspid aortic valves
The study objective was to analyze long-term growth and outcomes of the distal aorta after open acute type A aortic dissection repair in patients with bicuspid aortic valves or tricuspid aortic valves without connective tissue disease. From 1996 to 2021, 60 patients with bicuspid aortic valves and 6...
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| Veröffentlicht in: | The Journal of thoracic and cardiovascular surgery 2024-08, Vol.168 (2), p.453-462 |
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| container_title | The Journal of thoracic and cardiovascular surgery |
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| creator | Titsworth, Marc Graham, Nathan J. Orelaru, Felix Ahmad, Rana-Armaghan Wu, Xiaoting Kim, Karen M. Fukuhara, Shinichi Patel, Himanshu Deeb, G. Michael Yang, Bo |
| description | The study objective was to analyze long-term growth and outcomes of the distal aorta after open acute type A aortic dissection repair in patients with bicuspid aortic valves or tricuspid aortic valves without connective tissue disease.
From 1996 to 2021, 60 patients with bicuspid aortic valves and 655 patients with tricuspid aortic valves without connective tissue disease underwent open repair for acute type A aortic dissection. Data were collected from the local Society of Thoracic Surgeons database, medical record review, surveys, and the National Death Index and Michigan Death Index (December 12, 2021).
Compared with the tricuspid aortic valve group, the bicuspid aortic valve group was significantly younger, had more severe aortic insufficiency (33% vs 22%, P = .05), and had less hypertension (67% vs 78%, P = .05). Intraoperatively, patients with bicuspid aortic valves received more aortic root replacements (70% vs 26%, P |
| doi_str_mv | 10.1016/j.jtcvs.2022.12.009 |
| format | Article |
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From 1996 to 2021, 60 patients with bicuspid aortic valves and 655 patients with tricuspid aortic valves without connective tissue disease underwent open repair for acute type A aortic dissection. Data were collected from the local Society of Thoracic Surgeons database, medical record review, surveys, and the National Death Index and Michigan Death Index (December 12, 2021).
Compared with the tricuspid aortic valve group, the bicuspid aortic valve group was significantly younger, had more severe aortic insufficiency (33% vs 22%, P = .05), and had less hypertension (67% vs 78%, P = .05). Intraoperatively, patients with bicuspid aortic valves received more aortic root replacements (70% vs 26%, P < .001), less zone 2 aortic arch replacement (8.3% vs 20%, P = .03), and longer median cardiopulmonary bypass (233 vs 214 minutes, P = .05) and aortic crossclamp (184 vs 141 minutes, P < .001) times. The average annual aortic arch growth rate (0.23 mm/year vs 0.39 mm/year, P = .52) and descending aorta growth rate (0.61 mm/year vs 0.79 mm/year, P = .39) were similar between the bicuspid aortic valve and tricuspid aortic valve groups. The bicuspid aortic valve group had lower annual abdominal aorta growth (0.51 mm/year vs 0.68 mm/year, P = .03). The cumulative incidence of reoperation for the distal aorta (9.7% vs 16.0%, P = .77) was similar between the bicuspid aortic valve and tricuspid aortic valve groups. The 10-year survival was higher in the bicuspid aortic valve group (75.4% vs 66.0%, P = .03).
Patients with bicuspid aortic valves could be treated similarly as patients with tricuspid aortic valves without connective tissue disease in the setting of open acute type A aortic dissection repair.
[Display omitted]
Patients with BAV or TAV without CTD treated with open surgical repair for ATAAD had similar postoperative outcomes. The growth of the distal arch and descending aorta was not different between groups over time; however, the abdominal aorta grew at a lesser rate in the BAV group. The BAV group had greater long-term survival and similar reoperation rates due to aortic aneurysm and therefore potentially can be treated as patients with TAV without CTD with respect to ATAAD repair. [Display omitted]</description><identifier>ISSN: 0022-5223</identifier><identifier>ISSN: 1097-685X</identifier><identifier>EISSN: 1097-685X</identifier><identifier>DOI: 10.1016/j.jtcvs.2022.12.009</identifier><identifier>PMID: 36639287</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>acute type A aortic dissection ; bicuspid aortic valve ; tricuspid aortic valve</subject><ispartof>The Journal of thoracic and cardiovascular surgery, 2024-08, Vol.168 (2), p.453-462</ispartof><rights>2022 The American Association for Thoracic Surgery</rights><rights>Copyright © 2022 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c359t-899bd0bbd362b52c88ca9de4f97c7027923c72e8b6bc24c6b0e7fc93e75ffbd53</citedby><cites>FETCH-LOGICAL-c359t-899bd0bbd362b52c88ca9de4f97c7027923c72e8b6bc24c6b0e7fc93e75ffbd53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jtcvs.2022.12.009$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,781,785,3551,27929,27930,46000</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36639287$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Titsworth, Marc</creatorcontrib><creatorcontrib>Graham, Nathan J.</creatorcontrib><creatorcontrib>Orelaru, Felix</creatorcontrib><creatorcontrib>Ahmad, Rana-Armaghan</creatorcontrib><creatorcontrib>Wu, Xiaoting</creatorcontrib><creatorcontrib>Kim, Karen M.</creatorcontrib><creatorcontrib>Fukuhara, Shinichi</creatorcontrib><creatorcontrib>Patel, Himanshu</creatorcontrib><creatorcontrib>Deeb, G. Michael</creatorcontrib><creatorcontrib>Yang, Bo</creatorcontrib><title>Distal aortic progression following acute type A aortic dissection repair among patients with bicuspid and tricuspid aortic valves</title><title>The Journal of thoracic and cardiovascular surgery</title><addtitle>J Thorac Cardiovasc Surg</addtitle><description>The study objective was to analyze long-term growth and outcomes of the distal aorta after open acute type A aortic dissection repair in patients with bicuspid aortic valves or tricuspid aortic valves without connective tissue disease.
From 1996 to 2021, 60 patients with bicuspid aortic valves and 655 patients with tricuspid aortic valves without connective tissue disease underwent open repair for acute type A aortic dissection. Data were collected from the local Society of Thoracic Surgeons database, medical record review, surveys, and the National Death Index and Michigan Death Index (December 12, 2021).
Compared with the tricuspid aortic valve group, the bicuspid aortic valve group was significantly younger, had more severe aortic insufficiency (33% vs 22%, P = .05), and had less hypertension (67% vs 78%, P = .05). Intraoperatively, patients with bicuspid aortic valves received more aortic root replacements (70% vs 26%, P < .001), less zone 2 aortic arch replacement (8.3% vs 20%, P = .03), and longer median cardiopulmonary bypass (233 vs 214 minutes, P = .05) and aortic crossclamp (184 vs 141 minutes, P < .001) times. The average annual aortic arch growth rate (0.23 mm/year vs 0.39 mm/year, P = .52) and descending aorta growth rate (0.61 mm/year vs 0.79 mm/year, P = .39) were similar between the bicuspid aortic valve and tricuspid aortic valve groups. The bicuspid aortic valve group had lower annual abdominal aorta growth (0.51 mm/year vs 0.68 mm/year, P = .03). The cumulative incidence of reoperation for the distal aorta (9.7% vs 16.0%, P = .77) was similar between the bicuspid aortic valve and tricuspid aortic valve groups. The 10-year survival was higher in the bicuspid aortic valve group (75.4% vs 66.0%, P = .03).
Patients with bicuspid aortic valves could be treated similarly as patients with tricuspid aortic valves without connective tissue disease in the setting of open acute type A aortic dissection repair.
[Display omitted]
Patients with BAV or TAV without CTD treated with open surgical repair for ATAAD had similar postoperative outcomes. The growth of the distal arch and descending aorta was not different between groups over time; however, the abdominal aorta grew at a lesser rate in the BAV group. The BAV group had greater long-term survival and similar reoperation rates due to aortic aneurysm and therefore potentially can be treated as patients with TAV without CTD with respect to ATAAD repair. [Display omitted]</description><subject>acute type A aortic dissection</subject><subject>bicuspid aortic valve</subject><subject>tricuspid aortic valve</subject><issn>0022-5223</issn><issn>1097-685X</issn><issn>1097-685X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9kE1r3DAQhkVpaLZpf0Gh6NiLXX3ElnXoIaSfEMilhd6EPsapFq_lauQNufaXR9tNcsxpGOaZGd6HkHectZzx_uO23Ra_x1YwIVouWsb0C7LhTKumH7rfL8mG1UnTCSFPyWvELWNMMa5fkVPZ91KLQW3Iv88Ri52oTblET5ecbjIgxjTTMU1Tuo3zDbV-LUDL3QL04pEMERF8OYAZFhsztbtU2cWWCHNBehvLH-qiX3GJgdo50JKfuuONvZ32gG_IyWgnhLcP9Yz8-vrl5-X35ur624_Li6vGy06XZtDaBeZckL1wnfDD4K0OcD5q5RUTSgvplYDB9c6Lc987Bmr0WoLqxtGFTp6RD8e7NeTfFbCYXUQP02RnSCsaofpOKdlxWVF5RH1OiBlGs-S4s_nOcGYO8s3W_JdvDvINF6bKr1vvHx6sbgfhaefRdgU-HQGoMfcRskFfZXkIMVeXJqT47IN7iICa-w</recordid><startdate>20240801</startdate><enddate>20240801</enddate><creator>Titsworth, Marc</creator><creator>Graham, Nathan J.</creator><creator>Orelaru, Felix</creator><creator>Ahmad, Rana-Armaghan</creator><creator>Wu, Xiaoting</creator><creator>Kim, Karen M.</creator><creator>Fukuhara, Shinichi</creator><creator>Patel, Himanshu</creator><creator>Deeb, G. Michael</creator><creator>Yang, Bo</creator><general>Elsevier Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20240801</creationdate><title>Distal aortic progression following acute type A aortic dissection repair among patients with bicuspid and tricuspid aortic valves</title><author>Titsworth, Marc ; Graham, Nathan J. ; Orelaru, Felix ; Ahmad, Rana-Armaghan ; Wu, Xiaoting ; Kim, Karen M. ; Fukuhara, Shinichi ; Patel, Himanshu ; Deeb, G. Michael ; Yang, Bo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c359t-899bd0bbd362b52c88ca9de4f97c7027923c72e8b6bc24c6b0e7fc93e75ffbd53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>acute type A aortic dissection</topic><topic>bicuspid aortic valve</topic><topic>tricuspid aortic valve</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Titsworth, Marc</creatorcontrib><creatorcontrib>Graham, Nathan J.</creatorcontrib><creatorcontrib>Orelaru, Felix</creatorcontrib><creatorcontrib>Ahmad, Rana-Armaghan</creatorcontrib><creatorcontrib>Wu, Xiaoting</creatorcontrib><creatorcontrib>Kim, Karen M.</creatorcontrib><creatorcontrib>Fukuhara, Shinichi</creatorcontrib><creatorcontrib>Patel, Himanshu</creatorcontrib><creatorcontrib>Deeb, G. Michael</creatorcontrib><creatorcontrib>Yang, Bo</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of thoracic and cardiovascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Titsworth, Marc</au><au>Graham, Nathan J.</au><au>Orelaru, Felix</au><au>Ahmad, Rana-Armaghan</au><au>Wu, Xiaoting</au><au>Kim, Karen M.</au><au>Fukuhara, Shinichi</au><au>Patel, Himanshu</au><au>Deeb, G. Michael</au><au>Yang, Bo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Distal aortic progression following acute type A aortic dissection repair among patients with bicuspid and tricuspid aortic valves</atitle><jtitle>The Journal of thoracic and cardiovascular surgery</jtitle><addtitle>J Thorac Cardiovasc Surg</addtitle><date>2024-08-01</date><risdate>2024</risdate><volume>168</volume><issue>2</issue><spage>453</spage><epage>462</epage><pages>453-462</pages><issn>0022-5223</issn><issn>1097-685X</issn><eissn>1097-685X</eissn><abstract>The study objective was to analyze long-term growth and outcomes of the distal aorta after open acute type A aortic dissection repair in patients with bicuspid aortic valves or tricuspid aortic valves without connective tissue disease.
From 1996 to 2021, 60 patients with bicuspid aortic valves and 655 patients with tricuspid aortic valves without connective tissue disease underwent open repair for acute type A aortic dissection. Data were collected from the local Society of Thoracic Surgeons database, medical record review, surveys, and the National Death Index and Michigan Death Index (December 12, 2021).
Compared with the tricuspid aortic valve group, the bicuspid aortic valve group was significantly younger, had more severe aortic insufficiency (33% vs 22%, P = .05), and had less hypertension (67% vs 78%, P = .05). Intraoperatively, patients with bicuspid aortic valves received more aortic root replacements (70% vs 26%, P < .001), less zone 2 aortic arch replacement (8.3% vs 20%, P = .03), and longer median cardiopulmonary bypass (233 vs 214 minutes, P = .05) and aortic crossclamp (184 vs 141 minutes, P < .001) times. The average annual aortic arch growth rate (0.23 mm/year vs 0.39 mm/year, P = .52) and descending aorta growth rate (0.61 mm/year vs 0.79 mm/year, P = .39) were similar between the bicuspid aortic valve and tricuspid aortic valve groups. The bicuspid aortic valve group had lower annual abdominal aorta growth (0.51 mm/year vs 0.68 mm/year, P = .03). The cumulative incidence of reoperation for the distal aorta (9.7% vs 16.0%, P = .77) was similar between the bicuspid aortic valve and tricuspid aortic valve groups. The 10-year survival was higher in the bicuspid aortic valve group (75.4% vs 66.0%, P = .03).
Patients with bicuspid aortic valves could be treated similarly as patients with tricuspid aortic valves without connective tissue disease in the setting of open acute type A aortic dissection repair.
[Display omitted]
Patients with BAV or TAV without CTD treated with open surgical repair for ATAAD had similar postoperative outcomes. The growth of the distal arch and descending aorta was not different between groups over time; however, the abdominal aorta grew at a lesser rate in the BAV group. The BAV group had greater long-term survival and similar reoperation rates due to aortic aneurysm and therefore potentially can be treated as patients with TAV without CTD with respect to ATAAD repair. [Display omitted]</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>36639287</pmid><doi>10.1016/j.jtcvs.2022.12.009</doi><tpages>10</tpages></addata></record> |
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| subjects | acute type A aortic dissection bicuspid aortic valve tricuspid aortic valve |
| title | Distal aortic progression following acute type A aortic dissection repair among patients with bicuspid and tricuspid aortic valves |
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