Early Prognosis of Reduction Ascending Aortoplasty in Patients With Aortic Valve Disease: A Single Center's Experience.

BACKGROUND: Dilatation of the ascending aorta tends to develop in individuals with aortic valve disease. Reduction ascending aortoplasty (RAA) is an alternative procedure to ascending aortic replacement. This study was designed to identify the early prognosis of RAA for patients with aortic valve disease and dilatation of the ascending aorta.

METHODS: From January 2010 to December 2013, 102 patients with aortic valve disease and ascending aortic dilatation who had undergone aortic valve replacement combined with RAA were enrolled. Fifty-seven patients with bicuspid aortic valve (BAV group) and 45 patients without BAV (non-BAV group) were analyzed. The study endpoints were postoperative death, reoperation, stroke, and aorta-related adverse events.

RESULTS: Follow-up data were obtained from all patients. The mean follow-up time was 38.8 ± 13.0 months. More patients with mitral valve disease and tricuspid insufficiency were present in the non-BAV group. More patients with ascending aorta larger than 45 mm were present in the BAV group. Two patients died, and 1 patient experienced a stroke. There were no reoperations or aorta-related adverse events. The mean expansion degree and rate of ascending aorta were 0.39 ± 0.26 cm and 1.3 ± 0.8 mm/year, respectively, in patients with aortic redilatation. Redilatation was observed in the BAV group (37.0 ± 5.0 mm vs 35.5 ± 4.6 mm; p = 0.009), whereas the non-BAV group had no significant change.

CONCLUSIONS: Reduction ascending aortoplasty shows good early results in patients with aortic valve disease and dilatation of the ascending aorta. Redilatation tends to happen in patients with BAV, and long-term follow-up is necessary.