Progression of ascending aortopathy may not occur after transcatheter aortic valve replacement in severe bicuspid aortic stenosis.
Korean J Intern Med
; 36(2): 332-341, 2021 03.
Article
in En
| MEDLINE
| ID: mdl-31408927
ABSTRACT
BACKGROUND/AIMS:
We evaluated changes in the ascending aorta dimension post-transcatheter aortic valve replacement (TAVR) in bicuspid aortic valve (BiAV) and tricuspid aortic valve (TAV) patients.METHODS:
Patients with severe aortic stenosis undergoing TAVR at Seoul National University Hospital were consecutively recruited. Patients with less than 12 months' follow-up and/or with an ascending aorta size larger than 50 mm were excluded. The ascending aorta size was measured on a parasternal long axis view using transthoracic echocardiography.RESULTS:
Among the 67 patients who were included (age 76.5 ± 6.5 years; male 52.2%; AV area 0.67 ± 0.15 cm2), 19 (28.4%) had BiAV; 48 (71.6%) had TAV. The median (interquartile ranges) follow-up duration was 398 days (361 to 451). BiAV patients were younger (73.2 ± 7.2 vs. 77.8 ± 5.8, p = 0.008), and had lower incidences of chronic renal disease (5.3% vs. 35.4%, p = 0.014) and history of coronary intervention (15.8% vs. 50.0%, p = 0.013), than TAV patients. On pre-procedural echocardiography, the ascending aorta dimensions in BiAV patients were larger than those in TAV patients (40.5 ± 3.8 mm vs. 35.9 ± 4.2 mm, p < 0.005). The ascending aorta dimension changed minimally during follow-up; post-TAVR, the ascending aorta's growth rate was -0.11 ± 1.9 and 0.26 ± 1.8 mm/yr in patients with BiAV and TAV, respectively (p = 0.50). Progression of the ascending aorta's dimension postTAVR was not clinically significant in BiAV patients.CONCLUSION:
The concern about the progression of aortopathy in BiAV patients post-TAVR may not be a clinical issue. This should be confirmed in studies with a larger population and with a longer follow-up duration.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Aortic Valve Stenosis
/
Transcatheter Aortic Valve Replacement
/
Heart Valve Diseases
Type of study:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limits:
Aged
/
Aged80
/
Humans
/
Male
Country/Region as subject:
Asia
Language:
En
Journal:
Korean J Intern Med
Journal subject:
MEDICINA INTERNA
Year:
2021
Document type:
Article
Publication country:
COREA DEL SUR
/
CORÉIA DO SUL
/
KR
/
SOUTH KOREA