Bicuspid versus tricuspid aortic valve morphology in elective ascending aortic aneurysm surgery: A propensity score-matched analysis.
Bicuspid vs tricuspid aortic valve had similar 10-year survival after aneurysm surgery
Bicuspid versus tricuspid aortic valve morphology in elective ascending aortic aneurysm surgery: A propensity score-matched analysis.
To compare perioperative and long-term outcomes between bicuspid (BAV) and tricuspid (TAV) aortic valve patients undergoing elective ascending aortic aneurysm surgery using propensity score matching (propensity score matching).
We retrospectively analyzed 1340 consecutive adults who underwent elective ascending aortic surgery for aneurysm at a single high-volume center between January 2014 and December 2025.
10-year survival was similar with bicuspid versus tricuspid valves
Thirty-day mortality was 0.7% (n = 2 of 285) in the BAV group versus 1.05% (n = 3 of 285) in the TAV group (odds ratio, 0.66; 95% confidence interval, [CI], 0.11-3.98; P = 1.00).
Early postoperative complications did not differ between the 2 groups (all P > .05).
The cumulative incidence of late aortic reintervention at 10 years was 4.6% (95% CI, 2.1%-8.5%) in the BAV group versus 3.5% (95% CI, 1.4%-7.0%) in the TAV group (Gray test, P = .57).
In multivariable Cox regression, BAV morphology was not an independent predictor of mortality (hazard ratio, 0.92; 95% CI, 0.58-1.45; P = .74).
In this propensity score-matched cohort, BAV morphology was not associated with worse perioperative or long-term outcomes after elective ascending aortic surgery compared to TAV.
These findings support managing BAV-related aortopathy according to the same patient- and anatomy-driven principles used for TAV rather than based on valve morphology alone.