The following is a summary of the “Later aorta operation after aortic valve replacement for bicuspid aortic valve,” published in the March 2024 issue of Cardiology by Hachiro et al.
In this retrospective study, which lasted from January 2002 to December 2022, researchers investigated the long-term outcomes, specifically focusing on later aorta operations and overall mortality, in individuals who underwent aortic valve replacement for bicuspid aortic valve without concomitant aortic surgery.
A total of 274 patients who underwent aortic valve replacement for bicuspid aortic valve at the institution were initially included, of which 181 patients who did not undergo aortic surgery, following current guidelines, were retrospectively analyzed. The median follow-up duration was 6.1 years, with a completion rate of 97.8%. Only 1.7% of patients underwent later aorta operation during the follow-up period. Adjusting for overall death as a competing risk, the cumulative rate of later aorta operation at 10 years was 16.3%, while the estimated rate of freedom from overall death at 10 years was 83.7%. The Fine-Gray competing risk regression model revealed that aortic valve stenosis was the sole predictor of later aorta operation, with a hazard ratio of 8.477 (p = 0.012).
In multivariable Cox models, predictors of overall death included aortic valve stenosis (hazard ratio: 8.270, 95% confidence interval: 1.082–63.235; p = 0.042) and operation time (hazard ratio: 1.011, 95% confidence interval: 1.004–1.017; p = 0.002). In conclusion, individuals with a bicuspid aortic valve and ascending aortic diameter less than 45 mm demonstrate a low risk of later aorta operation following isolated aortic valve replacement.
Source: cardiothoracicsurgery.biomedcentral.com/articles/10.1186/s13019-024-02638-6