Knowledge of native valve anatomy is essential in follow-up of patients after aortic valve replacement

详细信息    查看全文

• 作者：Luc Cozijnsen^a ; ¹ ; ^{l.cozijnsen@gelre.nl" class="auth_mail" title="E-mail the corresponding author} ; Hester J. van der Zaag-Loonen^b ; ¹ ; Martinus A. Cozijnsen^c ; ¹ ; Richard L. Braam^a ; ¹ ; Robin H. Heijmen^d ; ¹ ; Barbara J.M. Mulder^e ; ¹
• 关键词：Bicuspid aortic valve ; Aortic valve replacement ; Native aortic valve anatomy
• 刊名：International Journal of Cardiology
• 出版年：2016
• 出版时间：15 December 2016
• 年：2016
• 卷：225
• 期：Complete
• 页码：172-176
• 全文大小：382 K

文摘

After aortic valve replacement (AVR), bicuspid aortic valve (BAV) patients continue to be at risk of aortic complications. Therefore, knowledge of native valve anatomy is important for follow-up. We aimed to determine the extent of which the presence of BAV disease is known in a regional post-AVR population.

<h4 id="absSec_2">Methodsh4>

The Electronical Medical Record system was used to collect all patients under follow-up after AVR. We documented their clinical data and used the operative report to determine valve phenotype; lacking reports were retrieved.

<h4 id="absSec_3">Resultsh4>

We identified 560 patients who underwent AVR between 1971 and 2012, with a median of 6.2 years follow-up postoperatively. Mean age at surgery was 66 years (SD13.2 years), and 319 patients (57%) were male. In 29 cases (5%), an operative report was not available and in 85 patients (16%) the report lacked a description of valve phenotype. In 446 patients, a surgeon's description of native valve was available: 299 patients (67%) had tricuspid aortic valve, 140 (31%) BAV, and 3 (1%) quadricuspid aortic valve. In 4 patients (1%) the description was non-conclusive. In 66/140 BAV patients the surgeon's diagnosis was not reported back to the referring cardiologist, which corresponded with 12% of all 560 AVR patients. Another 21% of these 560 lacked a clear description of native valve anatomy: no report, no native valve description or an unclear valve description.

<h4 id="absSec_4">Conclusionsh4>

Native valve anatomy was not known in one-third of AVR patients under follow-up, which included almost half of the BAV patients. This lack of knowledge withholds patients from appropriate ascending aorta surveillance.