Aneurysm Aortic Root, Aortic Valve, Bicuspid
Conditions
Keywords
valve sparing procedure, reimplantation
Brief summary
Aortic valve sparing operations are applied in patients with a non-calcified tricuspid or bicuspid aortic valve associated with a root aneurysm, in order to preserve the valve, and avoid new aortic dilatation by stabilizing the aortic valve anulus with a graft prosthesis. This results in a normal functioning aortic valve, with a low forward gradient across the left ventricular outflow tract. Little is known about how the repaired aortic valve behaves in conditions of controlled exercise, and how the gradients across the valve change during exercise.
Detailed description
In a cohort of patients operated on since 2000 with a valve sparing operation for aortic root aneurysm in the Department of Cardiac surgery of the University Hospital Ghent, Belgium, and with gradients at rest across the aortic valve of \<20mmHg, a graded exercise test on a bicycle (stepwise increase of afterload) will be performed, and the gradient across the aortic valve will be monitored by transthoracic echocardiography at each exercise level. Patients with tricuspid and bicuspid valves will be compared. An age matched, unoperated, and asymptomatic control group with normal functioning tricuspid and bicuspid valves will be examined with the same exercise protocol. The purpose of the study is the description of the gradients across the aortic valve during exercise, and the discrimination of risk factors that may induce increased gradients. The hypothesis is that patients with bicuspid valves will demonstrate higher gradients than patients with tricuspid valves, in operated and unoperated individuals.
Interventions
DIAGNOSTIC_TESTgraded bicycle test
the subjects perform an exercise test on a reclining bicycle, and perform against increasing afterload
Sponsors
University Hospital, Ghent
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
Yes
Inclusion criteria
* been operated with a valve sparing root procedure in the University Hospital Ghent, Belgium, since 2000 * being able to perform an exercise test on a reclining bicycle * normal left ventricular function
Exclusion criteria
* \<18 years or \>60 years of age * peak gradient across the aortic valve at rest of \>20mmHg * decreased left ventricular function
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Echocardiographic gradients in mmHg and velocity across the aortic valve in m/sec at each exercise level | from 1 year postoperatively | obtained with transthoracic echocardiography during exercise- echocardiographic flow velocity across the aortic valve (colour flow Doppler) and in the left ventricular outflow tract (pulsed-wave Doppler) were measured at regular time intervals during grade exercise, and during recovery - examination was recorded digitally |
| comparison between peak gradients in mmHg across tricuspid and bicuspid aortic valves | from 1 year postoperatively | obtained with transthoracic echocardiography during exercise, at each exercise level |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| comparison between gradients across aortic valve in unoperated and operated patients | 1 year | gradients in mmHg across the aortic valve, measured by transthoracic echocardiography, at increasing afterload levels, on a reclining bicycle |
Countries
Belgium
Outcome results
None listed