Author + information
- David Ranney,
- Ehsan Benrashid,
- Babatunde Yerokun,
- Hanghang Wang,
- John Harrison,
- Andrew Wang,
- Todd Kiefer and
- G. Chad Hughes
Objective: In regard to bicuspid aortic valve (BAV) aortopathy, 2016 ACC/AHA guideline clarifications suggest replacement at >4.5cm in patients undergoing AVR and >5.0cm for asymptomatic patients at low surgical risk (<4%) in experienced centers (Class IIa). The purpose of this study was to report outcomes of proximal aortic replacement in low-risk BAV patients in accordance with these guidelines.
Methods: Of 979 patients undergoing proximal aortic repair between 1/2005 and 9/2016 at a single high-volume referral aortic center, 389 (39.7%) had BAV aortopathy. N=336 were considered low risk as defined by age <75 and elective procedure status. Primary outcomes included 30-day/in-hospital results, long term survival and freedom from reoperation.
Results: Demographics and outcomes are listed in the Table. Mean aortic diameter at time of operation was 5.3 ± 0.6 cm. The incidences of perioperative death, stroke, and new dialysis dependent renal failure were 0%, 0.3%, and 0%, respectively. At a mean follow up of 41 months, proximal aortic reoperation was required in 2 of 336 patients (0.6%). Kaplan Meier estimates of overall survival at 10 years was 90.7%.
Conclusions: Elective repair of BAV aortopathy can be achieved with excellent early and long-term outcomes in high volume aortic centers. These data suggest recently clarified ACC/AHA guidelines are appropriate, although lowering the definition of low risk from 4% to <1% should be considered, as with the 2014 Canadian Cardiovascular Society Guidelines.
Room 204 A
Sunday, March 19, 2017, 8:38 a.m.-8:48 a.m.
Session Title: Highlighted Original Research: Valvular Heart Disease and the Year in Review
Abstract Category: 37. Valvular Heart Disease: Therapy
Presentation Number: 912-08
- 2017 American College of Cardiology Foundation