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The aortic stenosis complex: aortic valve, atherosclerosis, aortopathy

Konstantinos Dean Boudoulas1, Brian Wolfe1, Yazhini Ravi2

  • 1Department of Medicine, Division of Cardiovascular Medicine, The Ohio State University, Columbus, OH, USA.

Journal of Cardiology
|April 20, 2015
PubMed

Insights

Patients with aortic stenosis have high rates of coronary atherosclerosis. Bicuspid aortic valves are linked to a higher incidence of thoracic aortic aneurysms compared to tricuspid valves.

Area of Science:

  • Cardiology
  • Cardiovascular Surgery
  • Thoracic Surgery

Background:

  • Aortic stenosis is associated with coronary atherosclerosis in tricuspid aortic valve patients.
  • Thoracic aortic dilatation is common in bicuspid aortic valve patients.
  • Understanding these associations is crucial for managing aortic stenosis patients.

Purpose of the Study:

  • To determine the relationship between aortic stenosis, coronary atherosclerosis, and thoracic aortic aneurysm.
  • To compare these associations in patients with tricuspid versus bicuspid aortic valves undergoing aortic valve surgery.

Main Methods:

  • A study of 270 patients with severe aortic stenosis undergoing surgical aortic valve replacement.
  • Patients were categorized by aortic valve type: tricuspid (175) and bicuspid (95).

Main Results:

  • Coronary artery bypass grafting (CABG) plus aortic valve replacement (AVR) was more frequent in tricuspid than bicuspid valves (62.2% vs. 26.3%).
  • Thoracic aorta surgery for aneurysm was more common in bicuspid than tricuspid valves (27.3% vs. 3.4%).
  • Coronary atherosclerosis requiring CABG was higher in bicuspid valves than expected in the general population.

Conclusions:

  • Coronary atherosclerosis is prevalent in both tricuspid and bicuspid aortic valve stenosis patients.
  • Ascending aortic aneurysms are common in bicuspid aortic valve patients but not significantly higher in tricuspid aortic valve patients.
  • These findings impact the comprehensive evaluation and treatment strategies for patients with complex aortic conditions.
Abstract

Keywords:
Aortic aneurysmAortic stenosisBicuspid valveCoronary artery diseaseTricuspid valve

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