The Congenitally Malformed Aortic Valve in Type A Aortic Dissection: Its Frequency and Consequences.

IF 2.3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS American Journal of Cardiology Pub Date : 2024-11-22 DOI:10.1016/j.amjcard.2024.11.023
Kyle A McCullough, John B Eisenga, J Michael DiMaio, Charles S Roberts
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Abstract

A congenitally malformed aortic valve, unicuspid (UAV), or bicuspid (BAV), occurs in about 1% of the population and is known to be more frequent in patients with aortic dissection. The clinical and operative findings in a series of 134 patients with spontaneous, acute type A aortic dissection were studied, comparing patients with normal and abnormal aortic valve morphology. The aortic valve was normal in 123 of 134 (92%) patients and abnormal in 11 of 134 (8%) patients: BAV in 10 of 134 (7.5%) and UAV in 1 of 134 (0.7%). Demographics were similar between groups, except for a lower frequency of systemic hypertension in the UAV/BAV group (46 vs 82%, p <0.01). The University of Pennsylvania malperfusion class stratification was also similar in the 2 groups. The UAV/BAV group had a greater frequency of aortic root aneurysm (64 vs 18%, p <0.01) and a larger median root diameter (5.7 vs 4.6 cm, p = 0.02). In the UAV/BAV group, the entry tear was more frequently in proximal (intrapericardial) zone 0 (91 vs 62%, p = 0.049). The frequency of abnormal aortic media histology was similar. The rate of root replacement was higher in the UAV/BAV group and early mortality was similar. The frequency of congenitally malformed aortic valve in this series was 8 times higher than in the normal population. The 1 UAV in the series was the only severely stenotic valve. In patients with type A aortic dissection with a congenitally malformed valve, aortic root aneurysm was more common and the entry tear was nearly always proximal.

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A 型主动脉夹层中的先天性畸形主动脉瓣:其发生率和后果
先天性畸形主动脉瓣(单尖瓣(UAV)或双尖瓣(BAV))约占总人口的 1%,已知在主动脉夹层患者中更为常见。我们对 134 例自发性急性 A 型主动脉夹层(TAAD)患者的临床和手术结果进行了研究,并对主动脉瓣形态正常和异常的患者进行了比较。123/134(92%)例患者的主动脉瓣正常,11/134(8%)例患者的主动脉瓣异常:其中 10/134 例(7.5%)为 BAV,1/134 例(0.7%)为 UAV。两组患者的人口统计学特征相似,但 UAV/BAV 组患者的全身性高血压发生率较低(46 对 82%,P<0.05)。
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来源期刊
American Journal of Cardiology
American Journal of Cardiology 医学-心血管系统
CiteScore
4.00
自引率
3.60%
发文量
698
审稿时长
33 days
期刊介绍: Published 24 times a year, The American Journal of Cardiology® is an independent journal designed for cardiovascular disease specialists and internists with a subspecialty in cardiology throughout the world. AJC is an independent, scientific, peer-reviewed journal of original articles that focus on the practical, clinical approach to the diagnosis and treatment of cardiovascular disease. AJC has one of the fastest acceptance to publication times in Cardiology. Features report on systemic hypertension, methodology, drugs, pacing, arrhythmia, preventive cardiology, congestive heart failure, valvular heart disease, congenital heart disease, and cardiomyopathy. Also included are editorials, readers'' comments, and symposia.
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