@Article{,
AUTHOR = {Alexander C. Egbe, Heidi M. Connolly, Joseph T. Poterucha, Carole A. Warnes},
TITLE = {Bicuspid and Unicuspid Aortic Valve: Fate of Moderate/Severe Mixed Aortic Valve Disease},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {12},
YEAR = {2017},
NUMBER = {1},
PAGES = {24--31},
URL = {http://www.techscience.com/schd/v12n1/38717},
ISSN = {3071-1738},
ABSTRACT = {<b>Objectives.</b> There is a paucity of data about mixed aortic valve disease (MAVD) in patients with bicuspid/unicuspid
aortic valve (BAV). This study sought to describe the outcomes of patients with moderate/severe MAVD.<br/>
<b>Methods.</b> We queried our database for patients with BAV and moderate/severe MAVD seen between 1994 and
2013. We excluded patients with baseline New York Heart Association (NYHA) III/IV symptoms, left ventricular
ejection fraction <50%, aortic dimension >50 mm, and significant disease of other valves. The purpose of the study
was to determine the freedom from NYHA III/IV symptoms and aortic valve replacement (AVR).<br/>
<b>Results.</b> We identified 138 patients with moderate/severe MAVD; mean age was 51 ± 12 years; 112 (81%) were
males; and follow-up was 8.5 ± 4 years. Ninety-two patients (67%) underwent AVR within 3.7 ± 2.5 years. Mechanical prostheses were implanted in 73 patients (79%); 22 patients (26%) and 36 patients (39%) had concomitant coronary artery bypass graft and aorta replacement during AVR respectively. There were no surgical deaths. Freedom
from AVR was 84%, 51%, and 20% at 1, 5 and 10 years respectively. Predictors of AVR were age at presentation
(hazard ratio [HR] 5.22; confidence interval [CI] 3.10 to 6.64) for every decade increase in age; and having severe stenosis or regurgitation at the time of presentation (HR 1.32; CI 1.05 to 3.16).<br/>
<b>Conclusions.</b> Age and disease severity should be incorporated in the risk assessment of BAV patients with MAVD,
and patients with both risk factors should be monitored closely.},
DOI = {}
}