A retrospective comparative study of acute type A aortic dissection in patients with Marfan syndrome and bicuspid aortic valves

Abstract

To compare the clinical features of type A aortic dissection (AAD) in patients with Marfan syndrome (MFS) and bicuspid aortic valves (BAV). Data from patients undergoing surgery for acute AAD between April 2008 and April 2012 at our institute were retrospectively collected. Patients were categorized into MFS group (n = 39) and BAV group (n = 28) to investigate their clinical and prognostic features. Patients in MFS and BAV groups always experienced the sudden onset of chest pain. MFS patients tended to have younger age [(35 ± 8) y vs (47 ± 13) y, P < 0.001], wider aortic sinus [(55.4 ± 9.8) mm vs (42.6 ± 8.6) mm, P < 0.01] and higher rate of moderate-to-severe aortic regurgitation (69.2% vs 32.1%, P = 0.003). Patients in BAV group were featured with higher rate of moderate-to-severe aortic stenosis. Though the operation procedures were similar in both groups, the 30-day postoperative mortality was significantly higher among BAV patients (25.0% vs 5.1%, P = 0.020). MFS and BAV represent unique subgroups of acute type A aortic dissection. BAV-associated dissection demonstrated strikingly higher postoperative mortality in our study population.