The Study Of The Bicuspid Aortic Valve With Ascending Aortic Dilatation

Background and objective:Bicuspid aortic valve (BAV) is one of the most common congenital valvular diseases, and the rate of incidence of the disease is1%-2%. Aortic disease is an important part of BAV, which includes aortic dilatation, aortic aneurysm and aortic dissection. Patients with progressive aortic dilatation is more common in BAV than TAV. The purpose of the article is to study the changes of diameter of ascending aorta after valve replacement in patients with aortic valve disease and ascending aortic dilatation (ascending aorta diameter3.5cm～5.0cm).Methods:We select42patients with aortic valve disease and ascending aortic dilatation (ascending aorta diameter3.5cm～5.0cm) from December2006to December2012for the study (except for Marfan syndrome and ascending aortic dissection patients), and the study subjects were divided into BAV group (n=22)and TAV group(n=20). The BAV group has22patients, of which12patients with aortic stenosis,8patients with aortic stenosis and regurgitation,2patients with aortic regurgitation; The TAV group has20patients, of which8patients with aortic stenosis,10patients with aortic stenosis and regurgitation,2patients with aortic regurgitation. In addition, BAV group was divided into <43mm group and≥43mm group according to the diameter of the ascending aorta. All groups do simple aortic valve replacement surgery under CPB, without dealing with the ascending aorta.Results:According to the results of12months～36months follow-up, we find that the ascending aorta change rates in BAV group were:patients with aortic stenosis (0.89±0.66) mm/year, patients with aortic stenosis and regurgitation (0.76±0.54) mm/year, patients with aortic regurgitation (0.70±0.02) mm/years; the ascending aorta change rates in TAV group were:patients with aortic stenosis (-0.72±0.17) mm/year, patients with aortic stenosis and regurgitation (-0.70±0.35) mm/year, patients with aortic regurgitation (-0.61±0.07) mm/years. And the ascending aorta change rates in <43mm group is (0.58±0.23) mm/years,≥43mm group is (1.179±0.73) mm/years, significance at P<0.05.Conclusions:BAV patients with aortic dilatation of the ascending aorta (aortic diameter3.5cm～5.0cm), only doing aortic valve replacement surgery is not enough, because the dilatation of the ascending aorta after valve replacement still has a certain rate. And the bigger the diameter of ascending aorta is, the faster the dilation of ascending aorta develops.