• Evaldas Girdauskas, Mina Rouman, Kushtrim Disha, Beatrix Fey, Georg Dubslaff, Bernhard Theis, Iver Petersen, Matthias Gutberlet, Michael A Borger, and Thomas Kuntze.
• Department of Cardiovascular Surgery, University Heart Center, Hamburg, Germany. Electronic address: e.girdauskas@uke.de.
• J. Am. Coll. Cardiol. 2016 Apr 19; 67 (15): 1786-1796.

BackgroundThe correlation between bicuspid aortic valve (BAV) disease and aortopathy is not fully defined.ObjectivesThis study aimed to prospectively analyze the correlation between functional parameters of the aortic root and expression of aortopathy in patients undergoing surgery for BAV versus tricuspid aortic valve (TAV) stenosis.MethodsFrom January 1, 2012 through December 31, 2014, 190 consecutive patients (63 ± 8 years, 67% male) underwent aortic valve replacement ± proximal aortic surgery for BAV stenosis (n = 137, BAV group) and TAV stenosis (n = 53, TAV group). All patients underwent pre-operative cardiac magnetic resonance imaging to evaluate morphological/functional parameters of the aortic root. Aortic tissue was sampled during surgery on the basis of the location of eccentric blood flow contact with the aortic wall, as determined by cardiac magnetic resonance (i.e., jet sample and control sample). Aortic wall lesions were graded using a histological sum score (0 to 21).ResultsThe largest cross-sectional aortic diameters were at the mid-ascending level in both groups and were larger in BAV patients (40.2 ± 7.2 mm vs. 36.6 ± 3.3 mm, respectively, p < 0.001). The histological sum score was 2.9 ± 1.4 in the BAV group versus 3.4 ± 2.6 in the TAV group (p = 0.4). The correlation was linear and comparable between the maximum indexed aortic diameter and the angle between the left ventricular outflow axis and aortic root (left ventricle/aorta angle) in both groups (BAV group: r = 0.6, p < 0.001 vs. TAV group r = 0.45, p = 0.03, z = 1.26, p = 0.2). Logistic regression identified the left ventricle/aorta angle as an indicator of indexed aortic diameter >22 mm/m(2) (odds ratio: 1.2; p < 0.001).ConclusionsComparable correlation patterns between functional aortic root parameters and expression of aortopathy are found in patients with BAV versus TAV stenosis.Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

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