PMID- 33465798
OWN - NLM
STAT- MEDLINE
DCOM- 20220628
LR  - 20220708
IS  - 1439-1902 (Electronic)
IS  - 0171-6425 (Linking)
VI  - 70
IP  - 4
DP  - 2022 Jun
TI  - Does the 45 mm Size Cutoff for Ascending Aortic Replacement Predict Better Early 
      Outcomes in Bicuspid Aortic Valve?
PG  - 289-296
LID - 10.1055/s-0040-1722197 [doi]
AB  - BACKGROUND: The aim of this study is to test if the newly proposed 45 mm size 
      criterion for ascending aortic replacement (AAR) in bicuspid aortic valve (BAV) 
      patients undergoing aortic valve replacement (AVR) is predictive of improved 
      early outcomes. METHODS: Data of 306 BAV patients with an aortic diameter of 
      >/=45 mm undergoing AVR alone or with AAR were retrospectively analyzed. Patients 
      were divided into groups of AVR + AAR (n = 220) and AVR only (n = 86) based on if 
      surgery was performed according to the 45 mm criterion. End point was early 
      adverse events, including 30-day and in-hospital mortality, cardiac events, acute 
      renal failure, stroke, and reoperation for bleeding. Cox regression was used to 
      assess if conformance to 45 mm criterion could predict fewer early adverse 
      events. RESULTS: AVR + AAR group had significantly higher postoperative left 
      ventricular ejection fraction (LVEF) (0.59 +/- 0.09 vs. 0.55 +/- 0.11, p = 0.006) and 
      longer cardiopulmonary bypass (CPB) time (128 vs. 111 minutes, p = 0.002). Early 
      adverse events occurred in 45 patients (14.7%), which was more prevalent in the 
      AVR-only group (22.1% vs. 11.8%, p = 0.020). Conformance to the 45 mm criterion 
      predicted lower rate of early adverse events (hazard ratio [HR]: 0.53, 95% 
      confidence interval [CI]: 0.28-0.98, p = 0.042). After adjustment for gender, 
      age, AAo diameter, sinuses of Valsalva diameter, preoperative LVEF, Sievers 
      subtypes, BAV valvulopathy, and CPB and cross-clamp times, conformance to the 45 
      mm size criterion still predicted lower incidence of early adverse events (HR: 
      0.37, 95% CI: 0.15-0.90, p = 0.028). CONCLUSIONS: This study shows that 
      conformance to 45 mm size cutoff for preemptive AAR during aortic valve 
      replacement in patients with BAV was not associated with increased risk for 
      adverse events and may improve early surgical outcomes.
CI  - Thieme. All rights reserved.
FAU - Li, Yi-Jia
AU  - Li YJ
AD  - Department of Echocardiography, Beijing Anzhen Hospital, Capital Medical 
      University, and Beijing Institute of Heart Lung and Blood Vessel Diseases, 
      Beijing, China.
FAU - Ma, Wei-Guo
AU  - Ma WG
AUID- ORCID: 0000-0003-3873-0837
AD  - Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical 
      University, and Beijing Institute of Heart Lung and Blood Vessel Diseases, 
      Beijing, China.
FAU - Qi, Yue
AU  - Qi Y
AD  - Department of Epidemiology, Beijing Anzhen Hospital, Capital Medical University, 
      and Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China.
FAU - Zhu, Jun-Ming
AU  - Zhu JM
AD  - Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical 
      University, and Beijing Institute of Heart Lung and Blood Vessel Diseases, 
      Beijing, China.
FAU - Yang, Ya
AU  - Yang Y
AD  - Department of Echocardiography, Beijing Anzhen Hospital, Capital Medical 
      University, and Beijing Institute of Heart Lung and Blood Vessel Diseases, 
      Beijing, China.
FAU - Sun, Li-Zhong
AU  - Sun LZ
AD  - Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical 
      University, and Beijing Institute of Heart Lung and Blood Vessel Diseases, 
      Beijing, China.
LA  - eng
PT  - Journal Article
DEP - 20210119
PL  - Germany
TA  - Thorac Cardiovasc Surg
JT  - The Thoracic and cardiovascular surgeon
JID - 7903387
SB  - IM
MH  - Aortic Valve/diagnostic imaging/surgery
MH  - *Aortic Valve Stenosis/diagnostic imaging/etiology/surgery
MH  - *Bicuspid Aortic Valve Disease
MH  - *Heart Valve Prosthesis Implantation/adverse effects
MH  - Humans
MH  - Retrospective Studies
MH  - Stroke Volume
MH  - Treatment Outcome
MH  - Ventricular Function, Left
COIS- None declared.
EDAT- 2021/01/20 06:00
MHDA- 2022/06/29 06:00
CRDT- 2021/01/19 20:15
PHST- 2021/01/20 06:00 [pubmed]
PHST- 2022/06/29 06:00 [medline]
PHST- 2021/01/19 20:15 [entrez]
AID - 10.1055/s-0040-1722197 [doi]
PST - ppublish
SO  - Thorac Cardiovasc Surg. 2022 Jun;70(4):289-296. doi: 10.1055/s-0040-1722197. Epub 
      2021 Jan 19.