The impact of coronary anomalies on the outcome in aortic valve surgery: comparison of bicuspid aortic valve versus tricuspid aortic valve morphotype
Open accessAbstract
OBJECTIVES: The association of anomalous anatomy of coronary arteries and bicuspid aortic valve (BAV) has been sporadically reported. Our aim was to evaluate the prevalence of coronary anomalies between BAV and tricuspid aortic valve (TAV) and to analyse their impact on major adverse cardiac events during and after aortic valve surgery. METHODS: A total of 1099 consecutive patients who received preoperative coronary evaluation and elective aortic valve replacement/repair between January 2013 and July 2016 at our institution were involved. Based on surgical inspection at the open-heart surgery, a total of 345 (32%) patients were diagnosed with BAV, whereas the remaining 754 (68%) patients had TAV. Coronary anatomy was evaluated by preoperative coronary angiography (n = 1084) or multislice computed tomography (n = 15). The primary end-point was the prevalence of coronary anomalies in BAV versus TAV cohort. Secondary end-points included postoperative cardiac ischaemia markers, postoperative coronary artery imaging or interventions and hospital mortality. RESULTS: A total of 46 (4%) coronary anomalies were detected and were significantly more frequent in the BAV group (7% vs 3%, P = 0.001). Postoperative markers of myocardial injury (creatine kinase/creatine kinase-MB and troponin) were increased and the need for postoperative coronary angiography/percutaneous coronary intervention was significantly higher in patients with coronary anomalies (12% vs 1%, P < 0.001). CONCLUSIONS: Our study revealed significantly increased prevalence of coronary anomalies in BAV patients when compared with their tricuspid counterparts. Patients with diagnosed coronary anomalies had more postoperative ischaemic cardiac events that resulted in increased morbidity of this cohort.
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Unusual coronary anatomy may necessitate modifications to the operative approach and can lead to adverse surgical outcomes in individuals with undetected coronary anomalies.
“The cardiovascular surgeon needs to be aware of unusual coronary anatomy because it may necessitate modifications to the operative approach and can lead to adverse surgical outcomes in individuals with undetected coronary anomalies.398”
From Clinical practice guidelines for the care of girls and women with Turner syndrome. (2024) · cites this paper as [398]
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- Authors
- Naito, S., Petersen, J., Reichenspurner, H., & Girdauskas, E.
- Affiliations
- Universität Hamburg (DE)
- Corresponding author
- Naito, Shiho
- Venue
- Interactive Cardiovascular and Thoracic Surgery
- Publisher
- Oxford University Press (OUP)
- Published
- 2017-12-12
- Volume
- 26
- Issue
- 4
- Pages
- 617-622
- ISSN
- 1569-9285 (ISSN-L)
- 1569-9293
- OpenAlex
- W2775369705
- Cited by
- 46
- References
- 23
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 5 · 2023: 8 · 2022: 6 · 2021: 11 · 2020: 4 · 2019: 3 · 2018: 3
- FWCI
- 2.14
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Interactive Cardiovascular and Thoracic Surgery (publishedVersion)
- PubMed (publishedVersion)
- OPUS (Augsburg University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Valve Diseases and Treatments
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Aortic Disease and Treatment Approaches
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Coronary Artery Anomalies
- Keywords
- coronary artery anomalies, bicuspid aortic valve, tricuspid aortic valve, aortic valve surgery, aortic valve replacement, aortic valve repair, major adverse cardiac events, coronary angiography, percutaneous coronary intervention, in-hospital mortality
- MeSH terms
- Bicuspid Aortic Valve Disease, Adolescent, Adult, Aged, Aged, 80 and over, Aortic Valve, Child, Child, Preschool, Coronary Vessel Anomalies, Echocardiography, Female, Cardiac Surgical Procedures, Heart Valve Diseases, Humans, Infant, Male, Middle Aged, Tricuspid Valve, Treatment Outcome, Coronary Angiography, Young Adult, Multidetector Computed Tomography
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