Sofia A. Horvath1, Christos G. Mihos2, Juan P. Rodriguez-Escudero1, Hany M. Elmahdy1, Andres M. Pineda2, Gerald P. Rosen3, Juan Carlos Brenes2, Orlando Santana2
1Department of Internal Medicine at Mount Sinai Medical Center, Miami Beach, FL, 2Columbia University Division of Cardiology at Mount Sinai Heart Institute, Miami Beach, FL, 3Department of Anesthesiology at Mount Sinai Medical Center, Miami Beach, FL, USA
Background and aim of the study: The study aim was to evaluate the aortic valve and aortic root morphology in Hispanic patients with a bicuspid aortic valve (BAV). BAV disease is one of the most common congenital anomaly of the heart, and is associated with abnormalities of the aorta. Interracial differences have been described between Caucasian and African-American patients with BAV, which may have clinical and therapeutic implications. The clinical and anatomical spectrum of BAV disease in Hispanic patients has not been well established.
Methods: A retrospective review was conducted of all heart operations performed at the authors’ institution between April 2008 and June 2013. Patients with BAV who underwent aortic valve replacement (AVR) were identified. All echocardiograms available were reviewed in order to compare cusp morphology, valvular function, and ascending aorta dimensions between Hispanic and non-Hispanic individuals.
Results: A total of 291 patients (159 Hispanic, 132 non-Hispanic) with a mean age of 62 ± 13 years were
identified. The baseline characteristics were similar between the two groups. In both Hispanics and non-Hispanics, the most prevalent cusp morphology was fusion of the right and left coronary cusps (82% for both groups). The most common indication for surgery was aortic stenosis. Hispanic patients had a larger aortic annulus diameter (2.58 ± 0.32 cm versus 2.39 ± 0.39 cm, p = 0.04). However, this difference was not significant after adjusting for age, gender, body surface area, and the presence of moderate-to-severe aortic insufficiency. Ascending aortopathy was present in 42.7% of the total study population. Regardless of ethnicity, the most common pattern of aortopathy involved the tubular ascending aorta with mild to moderate root enlargement (type 1).
Conclusion: Compared with other ethnic groups, Hispanics with BAVs have similar aortic valve morphology and function, as well as comparable aortopathy.
The Journal of Heart Valve Disease 2015;24:683-688
|Bicuspid Aortic Valve and Aortic Root Morphology in Hispanic Patients|
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