Dilatación de la raíz aórtica en pacientes con válvula bicúspide tras la sustitución valvular aórtica

Background: Bicuspid aortic valve (BAV) has been closely correlated with aortic pathology. BAV patients have a high probability of being operated along their lifetime for aortic disease. Progression of aortic dilatation after aortic valve replacement (AVR) has not being definitely assessed. Methods: A total of 23 BAV with aortic diameter ≤ 45mm patients were followed for a mean of 8 years after AVR. Echocardiographic measurement of the aortic root and tubular aorta was done after a mean of 6 and 8 years post-operatively. Predictors for dilatation were estimated. Results: Paired comparison of aortic root diameter between 6 (34.6±7.4 mm) and 8 years (37.6±7.7 mm) of follow-up showed that its dimension increased significantly (p<0.023) while no differences were found with the tubular aorta. Dilatation was seen mainly in smokers, family history and dyslipemic patients. Univariate predictors for aortic root dilatation were: family history of BAV or aortic pathology, prosthesis size and body surface area (BSA). Multivariate regression evidenced only BSA (beta coefficient 11.5) and family history (beta coefficient 4.5) as significant predictors. Conclusion: Aortic root continues to dilate after AVR in BAV patients. Higher BSA and family history of aortic pathology were found as strong predictors of aortic root dilatation. These patients should be closely followed after AVR.