Results
A total of 165 patients were included during the study period, 48
patients (29.1%) had BAV, while TAV was found in 117 patients (70.9%).
The demographics, clinical
characteristics and perioperative outcomes are summarized in Table1. The
mean diameter of aortic root at baseline was comparable between the two
groups (33.3±4mm vs 33.6±4.4mm, p=0.717), but the mean diameter of
ascending aorta at baseline was larger in BAV group than in TAV group
(38±4.1mm vs 35.6±4.5mm, p=0.001, Fig. 1).
Follow-up data was obtained on all 165 hospital survivors. The median
follow-up was 7 years, up to a maximum of 15 years, with no difference
between BAV group and TAV group (P=0.883). During the follow-up, a total
of 10 patients(6.1%) died, including 5 in the BAV group while 5 in TAV
group(p=0.439) . The causes of late deaths were listed in Table 2. In
the BAV group, there were 2 cardiac related death, 1 patient died of
congestive heart failure, and 1 patient died of sudden cardiac death. In
the TAV-group, there were 2 cardiac related death, 1 patient died of
congestive heart failure and 1 patients suffered sudden cardiac death.
In both groups, there were no late deaths due to aortic dissection or
aortic rupture. The overall survival rate was 89% and 95.8% at 10
years postoperatively in BAV versus TAV groups (Plog
rank=0.138, Fig. 2).
Only 1 patient suffered aortic dissection and underwent proximal aortic
surgery during the follow up period. The patient, in the TAV-group, was
diagnosed as ascending aortic dissection 5 years after the initial AVR
procedure. The progression of the aortic root and ascending aorta
between the initial AVR surgery and the proximal aortic surgery were
20mm and 18mm . No patient in the BAV-group required proximal aortic
surgery.
During follow-up, there was no difference in progression of aortic root
(1.3±4.7mm vs 0.3±4mm, p=0.225) and ascending aorta (0.8±4.7mm vs
0.6±3.5mm, p=0.821. Fig. 3). When demographic, clinical and
echocardiographic variables were added to the unconditional model, The
diameter of ascending aorta at baseline (p<0.001) was a significant
predictor of progression in ascending aorta.