Cardiothoracic Surgery Unit at the Department of Molecular Medicine and Surgery, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.
J Thorac Cardiovasc Surg. 2013 Sep;146(3):605-10. doi: 10.1016/j.jtcvs.2012.07.039. Epub 2012 Sep 13.
Whether patients with bicuspid aortic valves are susceptible not only to ascending aortic dilatation but also to dilatation of the remaining aorta is uncertain. This study evaluated the possible correlation between ascending aortic dilatation and dilatation of the remaining aorta in patients with bicuspid and tricuspid aortic valves, respectively.
The entire aortas of 97 patients (bicuspid in 62, tricuspid in 35) undergoing replacement of the ascending aorta because of ascending aortic pathology (78 with and 19 without concurrent valve pathology) were preoperatively evaluated using computed tomography scanning.
Aortic dimensions distal to the ascending aorta were smaller in patients with bicuspid aortic valves than in patients with tricuspid aortic valves (P < .001): proximal arch: 3.20 ± 0.60 cm/3.80 ± 0.68 cm; distal arch: 2.90 ± 0.60 cm/3.40 ± 0.50 cm; isthmus, 2.95 ± 0.60 cm/3.50 ± 0.60 cm; descending aorta: 2.70 ± 0.50 cm/3.20 ± 0.65 cm; suprarenal aorta: 2.30 ± 0.40 cm/2.70 ± 0.43 cm; infrarenal aorta: 1.90 ± 0.48 cm/2.20 ± 0.35 cm, respectively. Concomitant pathologic dilatation of the descending aorta was more common in patients with tricuspid aortic valves (37%) than in patients with bicuspid aortic valves (5%) (P < .001). Neither valvular pathology nor bicuspid aortic valve phenotype influenced the aortic dimensions in the bicuspid group (P > .2).
Patients with bicuspid aortic valves and dilatation of the ascending aorta consistently had smaller dimensions of the remaining aorta compared with patients with tricuspid aortic valves. Concomitant dilatation of the descending aorta was predominantly found in patients with tricuspid aortic valves.
二叶式主动脉瓣患者不仅易发生升主动脉扩张，而且剩余主动脉也可能扩张，这一点尚不确定。本研究分别评估了二叶式和三叶式主动脉瓣患者升主动脉扩张与剩余主动脉扩张之间的可能相关性。
对 97 例行升主动脉置换术的患者（二叶式 62 例，三叶式 35 例）的整个主动脉进行术前计算机断层扫描评估，这些患者均因升主动脉病变而行升主动脉置换术（78 例伴或不伴同期瓣膜病变）。
二叶式主动脉瓣患者的升主动脉远端主动脉尺寸小于三叶式主动脉瓣患者（P＜0.001）：升主动脉近端：3.20±0.60cm/3.80±0.68cm；升主动脉远端：2.90±0.60cm/3.40±0.50cm；主动脉峡部：2.95±0.60cm/3.50±0.60cm；降主动脉：2.70±0.50cm/3.20±0.65cm；肾上主动脉：2.30±0.40cm/2.70±0.43cm；肾下主动脉：1.90±0.48cm/2.20±0.35cm。三叶式主动脉瓣患者并发降主动脉病理性扩张更为常见（37%），而二叶式主动脉瓣患者则少见（5%）（P＜0.001）。二叶式主动脉瓣患者的瓣膜病变或二叶式主动脉瓣表型均不影响二叶式主动脉瓣组的主动脉尺寸（P＞0.2）。
与三叶式主动脉瓣患者相比，二叶式主动脉瓣伴升主动脉扩张的患者剩余主动脉的尺寸始终较小。三叶式主动脉瓣患者主要并发降主动脉扩张。
