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Outcomes of moderate stenosis in bicuspid aortic valve – surgery to all?
Session:
Posters (Sessão 1 - Écran 5) - Cirurgia Cardíaca
Speaker:
Ana Margarida Martins
Congress:
CPC 2023
Topic:
H. Interventional Cardiology and Cardiovascular Surgery
Theme:
26. Cardiovascular Surgery
Subtheme:
26.11 Cardiovascular Surgery - Other
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
Ana Margarida Martins; Pedro Alves da Silva; Joana Brito; Beatriz Valente Silva; Catarina Oliveira; Beatriz Garcia; Ana Abrantes; Catarina Gregório; Miguel Raposo; João Fonseca; Fausto J.Pinto; Ana Almeida
Abstract
<p style="text-align:start"><span style="font-size:16px"><strong>Introduction</strong></span></p> <p style="text-align:start"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">Bicuspid aortic valve (BAV) is the most common congenital heart defect, with high prevalence of significant aortic valvulopathy, especially stenosis. Current valvular guidelines are unclear regarding surgical indications for moderate aortic stenosis (AS). In the past few years, several studies have reported that patients (pts) with moderate AS might not have a benign prognosis. There is lack of information comparing outcomes of BAV pts submitted or not to surgery.</span></span></span></p> <p style="text-align:start"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">Methods</span></span></span></p> <p style="text-align:start"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">Series of patietns who did echo evaluation for bicuspid aortic disease on Echocardiography Laboratory from October 2010 to September 2021. Baseline demographic, clinical and echocardiography data were collected. Follow-up data with aortic surgery and all-cause mortality were registered. Pts were classified into 4 groups according to moderate or severe aortic stenosis and surgery: group 1moderate AS + surgery;group 2moderate AS; group 3 severe AS + </span></span></span><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">surgery; group 4 severe AS. Statistical analysis with Kaplan-Meier curves was used to compare survival between the 4 groups.</span></span></span></p> <p style="text-align:start"> </p> <p style="text-align:start"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">Results: We identified 55 BAV pts with, at least, moderate AS on echocardiogram (group 1: 11pts, group 2: 10pts, group 3: 25pts, group 4: 9pts).</span></span></span></p> <p style="text-align:start"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">Baseline characteristics were similar between groups without statistical differences (p=NS). Kaplan-Meier survival curves showed that patients submitted to surgery had better survival results independently of severity. However, pts with moderate AS not submitted to surgery had worse prognosis than moderate AS who underwent surgery and severe AS who underwent surgery (LogRank 11.726, p=0.008, figure 1).</span></span></span></p> <p style="text-align:start"> </p> <p style="text-align:start"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">Discussion: In our study, surgery in BAV pts with AS showed better survival results than pts without surgery. Although moderate AS in BAV pts have worse prognosis compared with those who underwent surgery. We found that moderate AS is associated with worse prognosis, not only in calcified aortic disease. Studies to understand predictors of worse prognosis in moderate AS, including BAV pts, are </span></span></span><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">warranted.</span></span></span></p>
Slides
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