Unidade Clínica de Valvopatias - Instituto do Coração (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo , SP - Brasil.
Arq Bras Cardiol. 2022 Mar;118(3):588-596. doi: 10.36660/abc.20201027.
The bicuspid aortic valve (BAV) affects 0.5 to 2% of the population and is associated with valve and aortic alterations. There is a lack of studies on the profile of these patients in the Brazilian population.
To describe the profile of patients with BAV undergoing valve and/or aortic surgery in a tertiary cardiology center, in addition to the outcomes related to the intervention.
Retrospective cohort including 195 patients (mean age 54±14 years, 73.8% male) diagnosed with BAV who underwent surgical approach (valvular and/or aorta) from 2014 to 2019. Clinical data, echocardiographic and tomographic studies were evaluated, as well as characteristics of the intervention and events in 30 days. A value of p<0.05 was considered statistically significant.
We found a high prevalence of aortic aneurysm (56.5%), with a mean diameter of 46.9±10.2 mm. Major aortic regurgitation was found in 25.1% and major aortic stenosis in 54.9%. Isolated aortic valve surgery was performed in 48.2%, isolated aortic surgery in 6.7% and combined surgery in 45.1%. The 30-day mortality was 8.2%. In the multivariate analysis, the predictors of the combined outcome at 30 days (death, atrial fibrillation and reoperation) were age (OR 1.044, 95% CI 1.009-1.081, p=0.014) and left ventricular mass index (OR 1.009, 95% CI 1.000-1.018, p=0.044).
Patients with BAV approached in our service have a higher incidence of aortopathy, with the additional need to evaluate the aorta with computed tomography or magnetic resonance imaging.
二叶式主动脉瓣（BAV）影响 0.5%至 2%的人群，并与瓣膜和主动脉改变相关。在巴西人群中，缺乏对这些患者特征的研究。
描述在一家三级心脏病中心接受瓣膜和/或主动脉手术的 BAV 患者的特征，以及与干预相关的结果。
回顾性队列纳入了 195 名（平均年龄 54±14 岁，73.8%为男性）被诊断为 BAV 并在 2014 年至 2019 年期间接受手术治疗（瓣膜和/或主动脉）的患者。评估了临床数据、超声心动图和断层扫描研究，以及 30 天内的干预特征和事件。p<0.05 被认为具有统计学意义。
我们发现主动脉瘤的高患病率（56.5%），平均直径为 46.9±10.2mm。25.1%存在严重主动脉瓣反流，54.9%存在严重主动脉瓣狭窄。单纯主动脉瓣手术占 48.2%，单纯主动脉手术占 6.7%，联合手术占 45.1%。30 天死亡率为 8.2%。在多变量分析中，30 天联合结局（死亡、心房颤动和再次手术）的预测因素是年龄（OR 1.044，95%CI 1.009-1.081，p=0.014）和左心室质量指数（OR 1.009，95%CI 1.000-1.018，p=0.044）。
在我们的服务中接受治疗的 BAV 患者主动脉病发病率较高，需要额外评估主动脉是否存在计算机断层扫描或磁共振成像异常。
