PMID- 31441553
OWN - NLM
STAT- MEDLINE
DCOM- 20200804
LR  - 20200804
IS  - 1540-8191 (Electronic)
IS  - 0886-0440 (Linking)
VI  - 34
IP  - 11
DP  - 2019 Nov
TI  - The fate of mild to moderate proximal aortic dilatation after isolated aortic 
      valve replacement in tricuspid aortic valve patients.
PG  - 1208-1214
LID - 10.1111/jocs.14217 [doi]
AB  - BACKGROUND: Proximal aortic dilatation is frequently associated with aortic valve 
      pathology. The treatment of mild to moderate proximal aortic dilatation (maximal 
      diameter: 40-50 mm) at the time of aortic valve replacement (AVR) is still 
      controversial. We retrospectively analyzed the fate and progression of the 
      proximal dilated aorta after isolated AVR in tricuspid aortic valve (TAV) 
      patients, to determine if ascending aortic replacement (AAR) is recommended at 
      the time of the initial AVR. METHODS: The review of our hospital database 
      revealed a subgroup of 127 TAV disease patients with mild to moderate ascending 
      aortic dilatation, who underwent isolated AVR (group I, n = 68) or AVR combined 
      AAR (group II, n = 59) from January 2000 to December 2013. Follow-up was obtained 
      through a telephone interview/outpatient interview. Adverse aortic events were 
      defined as aortic dissection/ rupture, or diameter of proximal aorta >/=55 mm, or 
      re-do aortic surgery contributable to the dilated aorta during follow-up. 
      RESULTS: There were no differences in age, gender, heart function, hypertension, 
      diabetes, smoking, chronic renal failure, and atrium fibrillation between two 
      groups except for the maximum aortic diameter (group I 43.91 +/- 2.0 vs group II 
      45.20 +/- 2.63, P < .05). The cross-clamp time and cardiopulmonary bypass time was 
      significantly less in group I than that in group II, owing to the replacement of 
      the proximal aorta. A total of 126 patients were discharged home successfully, 
      with 0.79% hospital mortality. There was no significant difference of hospital 
      mortality and morbidity between the two groups. Follow-up was successfully 
      obtained in 106 patients (84.13%). Mean follow-up time was (9.60 +/- 3.47) years. 
      The overall survival at 10-year follow-up was 72.46% +/- 6.42% in group I versus 
      74.55% +/- 6.87% in group II ( P = .73). The freedom from adverse aortic events at 
      10-year was 89.59% +/- 4.02% in group I versus 96.88% +/- 3.07% in group II ( 
      P = .09). No significant difference in survival rate and freedom from adverse 
      aortic events can be obtained between the two groups. CONCLUSION: Progression of 
      proximal aorta leading to adverse aortic events after isolated AVR in TAV 
      patients is infrequent. AVR alone is acceptable and reasonable in patients with 
      mild to moderate proximal aortic dilatation if connective tissue disorders are 
      not present.
CI  - (c) 2019 Wiley Periodicals, Inc.
FAU - Qin, Wei
AU  - Qin W
AD  - Department of Thoracic and Cardiovascular surgery, Nanjing First Hospital, 
      Nanjing Medical University, Nanjing, Jiangsu, China.
FAU - Li, Liangpeng
AU  - Li L
AD  - Department of Thoracic and Cardiovascular surgery, Nanjing First Hospital, 
      Nanjing Medical University, Nanjing, Jiangsu, China.
FAU - Li, Jian
AU  - Li J
AD  - Department of Thoracic and Cardiovascular surgery, Nanjing First Hospital, 
      Nanjing Medical University, Nanjing, Jiangsu, China.
FAU - Su, Cunhua
AU  - Su C
AD  - Department of Thoracic and Cardiovascular surgery, Nanjing First Hospital, 
      Nanjing Medical University, Nanjing, Jiangsu, China.
FAU - Huang, Fuhua
AU  - Huang F
AD  - Department of Thoracic and Cardiovascular surgery, Nanjing First Hospital, 
      Nanjing Medical University, Nanjing, Jiangsu, China.
FAU - Chen, Xin
AU  - Chen X
AUID- ORCID: 0000-0001-8317-5129
AD  - Department of Thoracic and Cardiovascular surgery, Nanjing First Hospital, 
      Nanjing Medical University, Nanjing, Jiangsu, China.
LA  - eng
GR  - No.BK20160132/the Young Program of the Natural Science Foundation of Jiangsu 
      Province/
GR  - No.81870193/the Program of National Natural Science Foundation of China/
GR  - No.81600225/the Young Program of National Natural Science Foundation of China/
PT  - Journal Article
DEP - 20190823
PL  - United States
TA  - J Card Surg
JT  - Journal of cardiac surgery
JID - 8908809
SB  - IM
MH  - Aortic Valve/pathology/*surgery
MH  - Dilatation, Pathologic
MH  - *Heart Valve Prosthesis Implantation
MH  - Humans
MH  - Tricuspid Valve/*surgery
OTO - NOTNLM
OT  - aortic valve replacement
OT  - aortopathy
OT  - ascending aorta replacement
OT  - proximal aortic dilatation
EDAT- 2019/08/24 06:00
MHDA- 2020/08/05 06:00
CRDT- 2019/08/24 06:00
PHST- 2019/08/24 06:00 [pubmed]
PHST- 2020/08/05 06:00 [medline]
PHST- 2019/08/24 06:00 [entrez]
AID - 10.1111/jocs.14217 [doi]
PST - ppublish
SO  - J Card Surg. 2019 Nov;34(11):1208-1214. doi: 10.1111/jocs.14217. Epub 2019 Aug 
      23.