ObjectiveTo assess early and mid-term outcomes and our clinical experience of reduction ascending aortoplasty (RAA) for patients with aortic valve disease and ascending aortic dilatation, and improve treatment effects. MethodsClinical data of 36 patients with aortic valve disease and ascending aortic dilatation who underwent aortic valve replacement and RAA in Fu Wai Hospital between January 2002 and August 2010 were retrospectively analyzed. There were 26 male and 10 female patients with their age of 7-72 (51±16) years. Ascending aorta diameter (AAD) was measured by echocardiography preoperatively, postoperatively, during follow-up and compared. ResultsThere was no perioperative death. Cardiopulmonary bypass time was 96.2±28.3 minutes, and aortic cross-clamp time was 69.2±22.1 minutes. Posto-perative hospital stay was 11.0±7.8 days. All the 36 patients were followed up after discharge for 1.1-9.0 (4.0±2.3) years. During follow-up, there was 1 death, but none of the patients needed reoperation. Echocardiography showed normal aortic valve function. Postoperative AAD was significantly smaller than preoperative AAD (36.4±6.1 mm vs. 46.8±4.6 mm, t=13.12, P=0.00). AAD during follow-up was significantly larger than postoperative AAD (40.8±6.8 mm vs. 36.4±6.1 mm, t=-2.64, P=0.01) but significantly smaller than preoperative AAD (40.8±6.8 mm vs. 46.8±4.6 mm, t=3.48, P=0.00). ConclusionEarly and mid-term outcomes of RAA are satisfactory for patients with aortic valve disease and ascending aortic dilatation, but long-term results need further observation.
ObjectiveTo find the relationship between bicuspid aortic valve (BAV) and the dilatation or aneurysm of the aorta using electrocardiogram-gated computed tomography angiography (CTA). MethodsWe collected the clinical data of the BAV coexisting with suspected aortic dilatation or aneurysm from February 2012 through April 2015. A total of 124 patients were analyzed retrospectively. There were 97 males and 27 females at an anverage age of 50.35±16.26 years. According to the CTA, patients were classified into two groups: a pure BAV(without raphe) group and a BAV (with raphe) group. we recorded the aortic diameters, gender, age, and so on. ResultsOf the 124 patients, 91 (73.4%) had BAV with raphe, and 33 patients (26.6%) had pure BAV. The analysis revealed that the diameter of the annulus (23.90±3.34 mm vs. 21.74±3.46 mm, P=0.005), the sinuses of Valsalva (40.93±6.78 mm vs. 37.35±7.06 mm, P=0.022), the tubular portion of the ascending aorta (45.38±7.66 mm vs. 38.29±8.18 mm, P=0.0001), and the part of the aorta proximal to the innominate artery (34.19±4.98 mm vs. 30.23±6.62 mm, P=0.02) between patients with BAV with raphe and pure BAV had significant differences. And there was a significant difference in prevalence of dilatation of the aorta between patients with pure BAV and BAV with raphe [77/91 (84.6%) vs.18/31(58.1%), P=0.004]. Of the 91 BAV with raphe patients, we found 76 patients (83.5%) with right and left coronary cusps (R-L) fusion, 13 patients (14.3%) with right and non-coronary cusps (R-N) fusion, and 2 patients (1.2%) with left and non-coronary cusps (L-N) fusion. There was a statistical difference in the aortic root diameters between R-L fusion BAV and R-N fusion BAV. The diameter of the distal ascending aorta and proximal aortic arch between R-L and R-N fusion BAV had statistical differences. ConclusionsBAV with raphe is more common than pure BAV and is more often associated with dilatation and aneurysm of the ascending aorta. Otherwise R-L fusion BAV is associated with increased diameters of the aortic root, while R-N fusion BAV is associated with increased diameters of the distal ascending aorta and proximal arch.