# Ascending Aortic Progression After Isolated Aortic Valve Replacement Among Patients with Bicuspid and Tricuspid Aortic Valves

## TL;DR

This study found that patients with bicuspid and tricuspid aortic valves have similar long-term outcomes after aortic valve replacement, including survival and risk of aortic complications.

## Contribution

The study demonstrates that bicuspid aortic valve is not a risk factor for adverse aortic events after isolated aortic valve replacement.

## Key findings

- BAV and TAV patients had similar ascending aortic dilation rates and freedom from adverse aortic events.
- Preoperative ascending aorta diameter was a significant predictor of adverse aortic events.
- Long-term survival differences between BAV and TAV groups disappeared after adjusting for age.

## Abstract

The aims of the present study were to compare the long-term outcomes for
ascending aortic dilatation and adverse aortic events after isolated aortic
valve replacement between patients with bicuspid aortic valve (BAV) and
tricuspid aortic valve ( TAV).

This retrospective study included 310 patients who had undergone isolated
aortic valve replacement with an ascending aorta diameter ≤ 45 mm
between January 2010 and September 2021. The patients were divided into BAV
group (n=90) and TAV group (n=220). The differences in the dilation rate of
the ascending aorta and long-term outcomes were analyzed.

Overall survival was 89 ± 4% in the BAV group vs. 75
± 6% in the TAV group at 10 years postoperatively
(P=0.007), yet this difference disappeared after adjusting
exclusively for age (P=0.343). The mean annual growth rate
of the ascending aorta was similar between the two groups during follow-up
(0.5 ± 0.6 mm/year vs. 0.4 ± 0.5 mm/year;
P=0.498). Ten-year freedom from adverse aortic events
was 98.1% in the BAV group vs. 95.0% in the TAV group
(P=0.636). Multivariable analysis revealed preoperative
ascending aorta diameter to be a significant predictor of adverse aortic
events (hazard ratio: 1.76; 95% confidence interval: 1.33 to 2.38;
P<0.001).

Our study revealed that the long-term survival and the risks of adverse
aortic events between BAV and TAV patients were similar after isolated
aortic valve replacement. BAV was not a risk factor of adverse aortic
events.