ArticleThe Journal of thoracic and cardiovascular surgery2020
Surgical repair of bicuspid aortopathy at small diameters: Clinical and institutional factors.
Article in The Journal of thoracic and cardiovascular surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 14 citations in OpenAlex.
- Bicuspid Aortic Valve in Heritable Thoracic Aortic Disease: Insights from the Montalcino Aortic Consortium.medRxiv : the preprint server for health sciences · 2025Article
- Outcomes of fenestrated-branched endovascular aortic repair of thoracoabdominal aortic aneurysms in patients with heritable thoracic aortic diseases.JTCVS techniques · 2025Article
- Midterm outcomes of concomitant ascending aorta replacement with rapid deployment aortic valve replacement.Journal of thoracic disease · 2025Article
- Outcomes of cardiothoracic surgery in women with Turner syndrome.Annals of cardiothoracic surgery · 2023Article
- The need for comprehensive multidisciplinary programs, complex interventions, and precision medicine for bicuspid aortic valve disease.Annals of cardiothoracic surgery · 2022Review
- Diameter-based decision making in bicuspid aortic valve aortopathy: is it time to expand our perspective?Annals of cardiothoracic surgery · 2022Article
- Cardiovascular Outcomes in Aortopathy: GenTAC Registry of Genetically Triggered Aortic Aneurysms and Related Conditions.Journal of the American College of Cardiology · 2022Article
- Is prophylactic root replacement needed to prevent future root aneurysm in bicuspid aortic valve patients?JTCVS open · 2021Article
- Impact of Regular Physical Activity on Aortic Diameter Progression in Paediatric Patients with Bicuspid Aortic Valve.Pediatric cardiology · 2021Article
- Applications of a Specialty Bicuspid Aortic Valve Program: Clinical Continuity and Translational Collaboration.Journal of clinical medicine · 2020Article
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Authors and funding
9 authors at 5 institutions in 2 countries.
Funding
Abstract
objectiveBicuspid aortic valve is a common risk factor for thoracic aortic aneurysm and dissection. Guidelines for elective ascending aortic intervention (AAI) in bicuspid aortic valve are derived from limited evidence, and the extent of practice variation due to patient and provider characteristics is unknown. Using data from 2 large cardiovascular registries, we investigated factors that influence decisions for AAI.
methodsAll bicuspid aortic valve cases with known aortic diameters and surgical status were included. We used multivariable logistic regression to profile predictors of isolated aortic valve replacement (AVR) or AVR+AAI, stratified by patient characteristics, surgical indications, and institution.
resultsWe studied 2861 subjects at 18 institutions from 1996 to 2015. The median aortic diameter of patients who underwent AVR+AAI varied widely across institutions (39-52 mm). Aortic diameters were <45 mm in 38% of patients undergoing AVR+AAI. Patients who underwent AAI at <45 mm, compared with those managed nonoperatively, were younger (54 ± 13 vs 61 ± 15 years; P < .001) with more frequent aortic stenosis (53% vs 28%; P < .001) and regurgitation (52% vs 18%; P < .001).
conclusionsClinical and institutional factors influence the timing of AAI and are associated with significant variability in ascending aortic diameter at AAI across institutions. More than one third of patients with a bicuspid aortic valve undergo AAI at aortic diameters <45 mm. Long-term outcomes of this subgroup of patients, who may manifest earlier and more severe disease, are needed to determine the risk-benefit ratio of routine aortic interventions at smaller diameters.
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