The aortic stenosis complex

Aortic valve, atherosclerosis, aortopathy

Konstantinos Dean Boudoulas, Brian Wolfe, Yazhini Ravi, Scott Lilly, Haikady N. Nagaraja, Chittoor Sai Sudhakar

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background: Aortic stenosis may be related to coronary atherosclerosis in patients with tricuspid aortic valve, while aortic dilatation often is present in patients with bicuspid aortic valve. We sought to define associations among aortic stenosis, coronary atherosclerosis, and thoracic aortic aneurysm in patients with tricuspid or bicuspid aortic valve undergoing surgery for aortic stenosis in a large referral medical center. Methods: Two hundred seventy patients with severe aortic stenosis (tricuspid 175, bicuspid 95) undergoing surgical aortic valve replacement (AVR) were studied. Results: Coronary artery bypass grafting (CABG) surgery plus AVR was required more often in tricuspid compared to bicuspid aortic valve [62.2% versus 26.3%; p<. 0.0001; odds ratio 4.5, confidence interval (CI) 2.5-8.3]. The incidence of coronary atherosclerosis requiring CABG in bicuspid aortic valve (26.3%) was greater than that expected in the general population for similar age. Thoracic aorta surgery due to aortic aneurysm plus AVR was performed more often in bicuspid compared to tricuspid aortic valve (27.3% versus 3.4%; p<. 0.0001; odds ratio 7.7, CI 3.0-22.1). The incidence of ascending aorta aneurysm requiring surgery, however, was not more common in tricuspid aortic valve (3.4%) to that expected in the general population for similar age. Conclusion: Incidence of coronary atherosclerosis is high in patients with aortic stenosis, both in those with tricuspid and bicuspid aortic valve. Incidence of ascending aortic aneurysm is high in patients with bicuspid, but not those with tricuspid aortic valve. These findings should be taken into consideration in the evaluation and management of patients with the aortic stenosis complex.

Original languageEnglish (US)
Pages (from-to)377-382
Number of pages6
JournalJournal of Cardiology
Volume65
Issue number5
DOIs
StatePublished - May 1 2015
Externally publishedYes

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Aortic Valve Stenosis
Aortic Valve
Atherosclerosis
Tricuspid Valve
Coronary Artery Disease
Bicuspid
Coronary Artery Bypass
Aortic Aneurysm
Incidence
Odds Ratio
Confidence Intervals
Thoracic Aortic Aneurysm
Thoracic Aorta
Surgical Instruments
Population
Thoracic Surgery
Aneurysm
Aorta
Dilatation
Referral and Consultation

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

The aortic stenosis complex : Aortic valve, atherosclerosis, aortopathy. / Boudoulas, Konstantinos Dean; Wolfe, Brian; Ravi, Yazhini; Lilly, Scott; Nagaraja, Haikady N.; Sai Sudhakar, Chittoor.

In: Journal of Cardiology, Vol. 65, No. 5, 01.05.2015, p. 377-382.

Research output: Contribution to journalArticle

Boudoulas, Konstantinos Dean ; Wolfe, Brian ; Ravi, Yazhini ; Lilly, Scott ; Nagaraja, Haikady N. ; Sai Sudhakar, Chittoor. / The aortic stenosis complex : Aortic valve, atherosclerosis, aortopathy. In: Journal of Cardiology. 2015 ; Vol. 65, No. 5. pp. 377-382.
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abstract = "Background: Aortic stenosis may be related to coronary atherosclerosis in patients with tricuspid aortic valve, while aortic dilatation often is present in patients with bicuspid aortic valve. We sought to define associations among aortic stenosis, coronary atherosclerosis, and thoracic aortic aneurysm in patients with tricuspid or bicuspid aortic valve undergoing surgery for aortic stenosis in a large referral medical center. Methods: Two hundred seventy patients with severe aortic stenosis (tricuspid 175, bicuspid 95) undergoing surgical aortic valve replacement (AVR) were studied. Results: Coronary artery bypass grafting (CABG) surgery plus AVR was required more often in tricuspid compared to bicuspid aortic valve [62.2{\%} versus 26.3{\%}; p<. 0.0001; odds ratio 4.5, confidence interval (CI) 2.5-8.3]. The incidence of coronary atherosclerosis requiring CABG in bicuspid aortic valve (26.3{\%}) was greater than that expected in the general population for similar age. Thoracic aorta surgery due to aortic aneurysm plus AVR was performed more often in bicuspid compared to tricuspid aortic valve (27.3{\%} versus 3.4{\%}; p<. 0.0001; odds ratio 7.7, CI 3.0-22.1). The incidence of ascending aorta aneurysm requiring surgery, however, was not more common in tricuspid aortic valve (3.4{\%}) to that expected in the general population for similar age. Conclusion: Incidence of coronary atherosclerosis is high in patients with aortic stenosis, both in those with tricuspid and bicuspid aortic valve. Incidence of ascending aortic aneurysm is high in patients with bicuspid, but not those with tricuspid aortic valve. These findings should be taken into consideration in the evaluation and management of patients with the aortic stenosis complex.",
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AU - Ravi, Yazhini

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AU - Sai Sudhakar, Chittoor

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