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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
Summary
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.
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