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Does the leaflet fusion subtype affect pattern and rate of growth in BAV aortopathy?: A study of 102 BAV aortopathy cases with a literature review


Hardikar, A and Harle, R, Does the leaflet fusion subtype affect pattern and rate of growth in BAV aortopathy?: A study of 102 BAV aortopathy cases with a literature review, Heart Lung and Circulation, 30, (7) pp. 1058-1066. ISSN 1443-9506 (2021) [Refereed Article]

Copyright Statement

Copyright 2020 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ)

DOI: doi:10.1016/j.hlc.2020.12.004


Background: Bicuspid aortic valves (BAV) and related aortopathy remain an intriguing topic. Not all BAVs get diseased and around 40% would develop aortic dilatation in their lifetime. If haemodynamic theory is to be believed, then leaflet fusion pattern should have an impact. This study sought to compare the association of aortic morphologies and rate of growth in a set of 102 BAV acropathies operated at a single centre, based on the fusion patterns.

Methods: Data on aortic valve replacements over a 10-year period was analysed from a prospectively maintained database. Of the 198 BAV undergoing surgery, 102 had aortic dilatation above 40 mm on echocardiogram. These underwent computed tomography (CT) aortograms and were followed up as a part of a database. The impact of leaflet fusion patterns on aortic dilatation pattern and rate was analysed.

Results: Of the 102, two patients had type 0 pathology and one had left-noncoronary (LN) leaflet fusion. Seventy-four (74) had type 1A or left-right (RL) fusion and 25 had type 1B right-noncoronary (RN) fusion. RL fusion had more males, were taller, bigger and had more proportion of aortic stenosis (AS). Aortic diameters, angles and growth rates at root, ascending/descending aorta and arch were not different. Regression analyses for size or growth did not show any significant impact of fusion pattern.

Conclusions:Left-right fusion pattern comprised three-quarters of BAV in this cohort and these patients were bigger, taller and had a greater proportion of males with increased rate of aortic stenosis. Despite these differences, there was no significant impact of fusion pattern on aortic size or rate of growth.

Item Details

Item Type:Refereed Article
Keywords:aorta, aortic dilatation, aortic growth, bicuspid aortic valve, fusion pattern
Research Division:Biomedical and Clinical Sciences
Research Group:Cardiovascular medicine and haematology
Research Field:Cardiology (incl. cardiovascular diseases)
Objective Division:Health
Objective Group:Clinical health
Objective Field:Treatment of human diseases and conditions
UTAS Author:Hardikar, A (Dr Ashutosh Hardikar)
ID Code:146877
Year Published:2021
Deposited By:Menzies Institute for Medical Research
Deposited On:2021-10-01
Last Modified:2021-11-24

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