La morfología y la lesión predominante de la válvula aórtica bicúspide determinan el patrón de aortopatía

Introduction: The heterogeneous nature of the bicuspid aortic valve and its association with the ascending aortic aneurysm has been recognized in many observational studies. The main aim in this study is to evaluate the existingassociation of the pattern of aortic disease with the morphology and primary valvular lesion of the bicuspid aortic valve.Methods: A total of 107 patients with bicuspid aortic valve underwent surgery between February 2007 and November 2013. The valvular morphology and the primary valve lesion with was identified using echocardiography. The aorta was measured at different levels using the pre-operative computed tomography.Results: The mean age at the time of surgery was significantly lower in patients with insufficiency than those with aortic stenosis (51 vs. 64 years old, P<.001). The aortic root was significantly higher amongst those with insufficiency (N = 24) compared to aortic stenosis patients (N= 39) (45 mm vs. 38 mm, P< 001) The right non-coronary leaflet fusion (N = 10) showed diameters for proximal, median and distal arch significantly higher than left-right leaflet fusion (N = 54), P<.05.Conclusions: Bicuspid aortic valve patients with aortic insufficiency as main lesion have surgical criteria at younger ages and are associated with aortic root aneurysms. The Right-Non coronary leaflet fusion has more prevalence of aortic arch aneurysm than the rest of the valvular morphologies. These results corroborate that in patients with bicuspid aortic valve, the area of aortic aneurysm can be linked directly with the morphology and the predominant valve lesion.(C) 2014 Sociedad Espanola de Cirugia Toracica-Cardiovascular. Published by Elseve Espana, S.L.U. All rights reserved.