{"title":"单尖主动脉瓣在年轻人中的现有证据:系统性回顾和 Metanalysis。","authors":"Andreina Carbone MD , Francesco Ferrara MD, PhD , Roberta Bottino MD , Valentina Russo MD , Salvatore Rega MD , Giuseppe Limongelli MD, PhD , Eduardo Bossone MD, PhD , Arturo Evangelista MD, PhD","doi":"10.1016/j.cpcardiol.2024.102884","DOIUrl":null,"url":null,"abstract":"<div><div>Unicuspid aortic valve (UAV) is a rare congenital valvular anomaly, often misdiagnosed as the more prevalent bicuspid aortic valve (BAV). The aim of this study was to explore demographic, clinical characteristics, diagnosis, surgical options, short and long term outcomes of young adults with UAV.</div><div>A systematic review and meta-analysis of literature were conducted for studies (1971-2024) including patients (≥ 14 years old) with diagnosis of UAV. Among the 2953 studies retrieved, 67 case reports, 6 case series (<em>n</em> = 130) and 13 retrospective studies (<em>n</em> = 918), were included in the analysis. Data from retrospective studies were aggregated using a random effects model for estimating the pooled risk ratio and mean difference.</div><div>UAV is mostly unicommissural in adults (mean age 36 years old at diagnosis, 76–79 % males). The most common conditions associated in UAV patients were aortic coarctation (from 3.8 to 12 %), ventricular septal defect (3 %) and Turner syndrome (3 %). In general, the diagnosis was performed with TTE and confirmed with TEE (+/- 3D-TEE). The most common types of surgery were AVR. Dilated ascending aorta was described in 44 % and 35 % of retrospective studies and case reports, respectively. Concomitant ascending aorta replacement/repair was reported 38 % and 27 % of retrospective studies and case reports, respectively. Overall survival was reported in 3 studies, ranging from 95 to 98 % at 10 years.</div><div>UAV should be considered a separate entity from BAV. Further investigations with regards to the possibility of a familial incidence, associated histopathological changes in the aorta, and ideal follow up and intervention are needed.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 1","pages":"Article 102884"},"PeriodicalIF":3.0000,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Current evidence of unicuspid aortic valve in young adults: A systematic review and metanalysis\",\"authors\":\"Andreina Carbone MD , Francesco Ferrara MD, PhD , Roberta Bottino MD , Valentina Russo MD , Salvatore Rega MD , Giuseppe Limongelli MD, PhD , Eduardo Bossone MD, PhD , Arturo Evangelista MD, PhD\",\"doi\":\"10.1016/j.cpcardiol.2024.102884\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><div>Unicuspid aortic valve (UAV) is a rare congenital valvular anomaly, often misdiagnosed as the more prevalent bicuspid aortic valve (BAV). The aim of this study was to explore demographic, clinical characteristics, diagnosis, surgical options, short and long term outcomes of young adults with UAV.</div><div>A systematic review and meta-analysis of literature were conducted for studies (1971-2024) including patients (≥ 14 years old) with diagnosis of UAV. Among the 2953 studies retrieved, 67 case reports, 6 case series (<em>n</em> = 130) and 13 retrospective studies (<em>n</em> = 918), were included in the analysis. Data from retrospective studies were aggregated using a random effects model for estimating the pooled risk ratio and mean difference.</div><div>UAV is mostly unicommissural in adults (mean age 36 years old at diagnosis, 76–79 % males). The most common conditions associated in UAV patients were aortic coarctation (from 3.8 to 12 %), ventricular septal defect (3 %) and Turner syndrome (3 %). In general, the diagnosis was performed with TTE and confirmed with TEE (+/- 3D-TEE). The most common types of surgery were AVR. Dilated ascending aorta was described in 44 % and 35 % of retrospective studies and case reports, respectively. Concomitant ascending aorta replacement/repair was reported 38 % and 27 % of retrospective studies and case reports, respectively. Overall survival was reported in 3 studies, ranging from 95 to 98 % at 10 years.</div><div>UAV should be considered a separate entity from BAV. Further investigations with regards to the possibility of a familial incidence, associated histopathological changes in the aorta, and ideal follow up and intervention are needed.</div></div>\",\"PeriodicalId\":51006,\"journal\":{\"name\":\"Current Problems in Cardiology\",\"volume\":\"50 1\",\"pages\":\"Article 102884\"},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2024-10-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Current Problems in Cardiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S014628062400519X\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Current Problems in Cardiology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S014628062400519X","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Current evidence of unicuspid aortic valve in young adults: A systematic review and metanalysis
Unicuspid aortic valve (UAV) is a rare congenital valvular anomaly, often misdiagnosed as the more prevalent bicuspid aortic valve (BAV). The aim of this study was to explore demographic, clinical characteristics, diagnosis, surgical options, short and long term outcomes of young adults with UAV.
A systematic review and meta-analysis of literature were conducted for studies (1971-2024) including patients (≥ 14 years old) with diagnosis of UAV. Among the 2953 studies retrieved, 67 case reports, 6 case series (n = 130) and 13 retrospective studies (n = 918), were included in the analysis. Data from retrospective studies were aggregated using a random effects model for estimating the pooled risk ratio and mean difference.
UAV is mostly unicommissural in adults (mean age 36 years old at diagnosis, 76–79 % males). The most common conditions associated in UAV patients were aortic coarctation (from 3.8 to 12 %), ventricular septal defect (3 %) and Turner syndrome (3 %). In general, the diagnosis was performed with TTE and confirmed with TEE (+/- 3D-TEE). The most common types of surgery were AVR. Dilated ascending aorta was described in 44 % and 35 % of retrospective studies and case reports, respectively. Concomitant ascending aorta replacement/repair was reported 38 % and 27 % of retrospective studies and case reports, respectively. Overall survival was reported in 3 studies, ranging from 95 to 98 % at 10 years.
UAV should be considered a separate entity from BAV. Further investigations with regards to the possibility of a familial incidence, associated histopathological changes in the aorta, and ideal follow up and intervention are needed.
期刊介绍:
Under the editorial leadership of noted cardiologist Dr. Hector O. Ventura, Current Problems in Cardiology provides focused, comprehensive coverage of important clinical topics in cardiology. Each monthly issues, addresses a selected clinical problem or condition, including pathophysiology, invasive and noninvasive diagnosis, drug therapy, surgical management, and rehabilitation; or explores the clinical applications of a diagnostic modality or a particular category of drugs. Critical commentary from the distinguished editorial board accompanies each monograph, providing readers with additional insights. An extensive bibliography in each issue saves hours of library research.