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Title: Anatomical and clinical predictors of valve dysfunction and aortic dilation in bicuspid aortic valve disease.
Authors: Evangelista, Arturo
Gallego, Pastora
Calvo-Iglesias, Francisco
Bermejo, Javier
Robledo-Carmona, Juan
Sánchez, Violeta
Saura, Daniel
Arnold, Roman
Carro, Amelia
Maldonado, Giuliana
Sao-Avilés, Augusto
Teixidó, Gisela
Galian, Laura
Rodríguez-Palomares, José
García-Dorado, David
Keywords: aortic dilation;aortic regurgitation;aortic stenosis;bicuspid aortic valve;echocardiography;valvular heart disease
metadata.dc.subject.mesh: Aorta
Aortic Valve
Aortic Valve Insufficiency
Aortic Valve Stenosis
Bicuspid Aortic Valve Disease
Dilatation, Pathologic
Heart Valve Diseases
Retrospective Studies
Risk Factors
Issue Date: 1-Sep-2017
Abstract: Bicuspid aortic valve (BAV) is associated with early valvular dysfunction and proximal aorta dilation with high heterogeneity. This study aimed to assess the determinants of these complications. Eight hundred and fifty-two consecutive adults diagnosed of BAV referred from cardiac outpatient clinics to eight echocardiographic laboratories of tertiary hospitals were prospectively recruited. Exclusion criteria were aortic coarctation, other congenital disorders or intervention. BAV morphotype, significant valve dysfunction and aorta dilation (≥2 Z-score) at sinuses and ascending aorta were established. Three BAV morphotypes were identified: right-left coronary cusp fusion (RL) in 72.9%, right-non-coronary (RN) in 24.1% and left-non-coronary (LN) in 3.0%. BAV without raphe was observed in 18.3%. Multivariate analysis showed aortic regurgitation (23%) to be related to male sex (OR: 2.80, p Normofunctional valves are more prevalent in BAV without raphe. Aortic stenosis is more frequent in BAV-RN and associated with some cardiovascular risk factors, whereas aortic regurgitation (AR) is associated with male sex and sigmoid prolapse. Although ascending aorta is the most commonly dilated segment, aortic root dilation is present in one-third of patients and associated with AR. Remarkably, BAV-RL increases the risk for dilation of the proximal aorta, whereas BAV-RN spares this area.
metadata.dc.identifier.doi: 10.1136/heartjnl-2017-311560
Appears in Collections:Producción 2020

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