Original articleAdult cardiacType A Aortic Dissection in Patients With Bicuspid Aortic Valve Aortopathy
Section snippets
Patients and Follow-up Protocol
Date were obtained from prospectively maintained aortic databases in 2 centers, 1 in the United States (Hospital of the University of Pennsylvania) and 1 in Germany (University Heart Center Freiburg). A total of 1140 patients without connective tissue diseases surgically treated for type A aortic dissections between 2002 and 2017 were included in the analysis. During this period 72 BAV patients (6%) and 1068 TAV patients (94%) underwent surgery. Surgical characteristics, clinical features,
Patient Characteristics
BAV patients were significantly younger when compared with TAV patients (P < .001) and were characterized by a lower occurrence of cardiovascular risk factors. Hypertension was significantly less prevalent in BAV patients (P < .001). Details of patient demographics and risk factors are summarized in Table 1.
Clinical Characteristics
Details on the clinical presentation and the extent of the aortic dissection are summarized in Table 2. The clinical presentation between BAV and TAV patients was similar.
Aortic Characteristics
More frequently in
Comment
The most essential findings of this study can be summarized as follows. First, type A aortic dissections occur in BAV patients at a younger age despite the lower incidence of cardiovascular risk factors. Second, although the clinical presentation was similar, the dissection affected the downstream aorta more often in TAV patients. Third, analysis of predissection diameters confirms that almost all TAV patients fail to meet the current criteria for elective ascending aortic replacement. Finally,
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Aortic wall thickness in dilated ascending aorta: Comparison between tricuspid and bicuspid aortic valve
2023, Archives of Cardiovascular DiseasesAscending Aorta Dissection Before 5.5 cm Diameter; “It Wasn't Raining When Noah Built the Ark”
2023, Heart Lung and CirculationCitation Excerpt :More specifically, according to IRAD data, approximately 60% of aTAAD occurred in aortas measuring less than 5.5 cm in diameter [15]. Similarly, the inefficacy of the current aortic diameter surgical threshold to prevent AD/rupture was also highlighted by Kreibech’s et al. study which reported that less than 5% of patients with tricuspid aortic valves who experienced aTAAD met the established surgical criteria [25]. Therefore, many leading experts in the treatment of aortic conditions have expressed the necessity of a ‘leftward shift’ in current thresholds, in order to reduce the incidence of aortic dissection [8,12,22].
Update in aortic dissection
2022, Trends in Cardiovascular MedicineCitation Excerpt :Generally, the decision to carry out elective surgery to correct a proximal thoracic aortic pathology aims to prevent acute Type A aortic dissection or rupture, and it has been based on the maximal aortic diameter. In the study by Kreibich et al., in patients who underwent Type A acute aortic dissection surgery, their pre-dissection ascending aortic diameters measured less than 5.5 cm in 96% of all those with a tricuspid aortic valve, and under 5.0 cm in 76% of all patients with a bicuspid aortic valve [3]. According to the latest research of Kruger et al., the ascending aorta's length can be regarded as correlating with the risk of a dissection developing.
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