{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T11:32:26Z","timestamp":1791286346268,"version":"4.1.0"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2011,3]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>There is debate concerning whether an aneurysmal ascending aorta should be replaced when associated with a dysfunctioning aortic valve that is to be replaced. To examine this issue, we divided the patients by type of aortic valve dysfunction\u2014either aortic stenosis (AS) or pure aortic regurgitation (AR)\u2014something not previously undertaken.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>Of 122 patients with ascending aortic aneurysm (unassociated with aortitis or acute dissection), the aortic valve was congenitally malformed (unicuspid or bicuspid) in 58 (98%) of the 59 AS patients, and in 38 (60%) of the 63 pure AR patients. Ascending aortic medial elastic fiber loss (EFL) (graded 0 to 4+) was zero or 1+ in 53 (90%) of the AS patients, in 20 (53%) of the 38 AR patients with bicuspid valves, and in all 12 AR patients with tricuspid valves unassociated with the Marfan syndrome. An unadjusted analysis showed that, among the 96 patients with congenitally malformed valves, the 38 AR patients had a significantly higher likelihood of 2+ to 4+ EFL than the 58 AS patients (crude odds ratio: 8.78; 95% confidence interval: 2.95, 28.13).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>These data strongly suggest that the type of aortic valve dysfunction\u2014AS versus pure AR\u2014is very helpful in predicting loss of aortic medial elastic fibers in patients with ascending aortic aneurysms and aortic valve disease.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circulationaha.110.972406","type":"journal-article","created":{"date-parts":[[2011,2,15]],"date-time":"2011-02-15T10:20:21Z","timestamp":1297765221000},"page":"896-903","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":101,"title":["Comparison of the Structure of the Aortic Valve and Ascending Aorta in Adults Having Aortic Valve Replacement for Aortic Stenosis Versus for Pure Aortic Regurgitation and Resection of the Ascending Aorta for Aneurysm"],"prefix":"10.1161","volume":"123","author":[{"given":"William Clifford","family":"Roberts","sequence":"first","affiliation":[{"name":"From the Baylor Heart and Vascular Institute (W.C.R., T.J.V., J.M.K.) and the Departments of Pathology (W.C.R.), Internal Medicine (Division of Cardiology) (W.C.R.), and Cardiothoracic Surgery (R.F.H., A.C.H., G.J.M., B.L.H.), and Institute for Health Care Research and Improvement (G.F.), Baylor Health Care System, Baylor University Medical Center, Dallas, TX; and the Department of Statistical Science (G.F.), Southern Methodist University, Dallas, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Travis James","family":"Vowels","sequence":"additional","affiliation":[{"name":"From the Baylor Heart and Vascular Institute (W.C.R., T.J.V., J.M.K.) and the Departments of Pathology (W.C.R.), Internal Medicine (Division of Cardiology) (W.C.R.), and Cardiothoracic Surgery (R.F.H., A.C.H., G.J.M., B.L.H.), and Institute for Health Care Research and Improvement (G.F.), Baylor Health Care System, Baylor University Medical Center, Dallas, TX; and the Department of Statistical Science (G.F.), Southern Methodist University, Dallas, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jong Mi","family":"Ko","sequence":"additional","affiliation":[{"name":"From the Baylor Heart and Vascular Institute (W.C.R., T.J.V., J.M.K.) and the Departments of Pathology (W.C.R.), Internal Medicine (Division of Cardiology) (W.C.R.), and Cardiothoracic Surgery (R.F.H., A.C.H., G.J.M., B.L.H.), and Institute for Health Care Research and Improvement (G.F.), Baylor Health Care System, Baylor University Medical Center, Dallas, TX; and the Department of Statistical Science (G.F.), Southern Methodist University, Dallas, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Filardo","sequence":"additional","affiliation":[{"name":"From the Baylor Heart and Vascular Institute (W.C.R., T.J.V., J.M.K.) and the Departments of Pathology (W.C.R.), Internal Medicine (Division of Cardiology) (W.C.R.), and Cardiothoracic Surgery (R.F.H., A.C.H., G.J.M., B.L.H.), and Institute for Health Care Research and Improvement (G.F.), Baylor Health Care System, Baylor University Medical Center, Dallas, TX; and the Department of Statistical Science (G.F.), Southern Methodist University, Dallas, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Robert Frederick","family":"Hebeler","sequence":"additional","affiliation":[{"name":"From the Baylor Heart and Vascular Institute (W.C.R., T.J.V., J.M.K.) and the Departments of Pathology (W.C.R.), Internal Medicine (Division of Cardiology) (W.C.R.), and Cardiothoracic Surgery (R.F.H., A.C.H., G.J.M., B.L.H.), and Institute for Health Care Research and Improvement (G.F.), Baylor Health Care System, Baylor University Medical Center, Dallas, TX; and the Department of Statistical Science (G.F.), Southern Methodist University, Dallas, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert Carl","family":"Henry","sequence":"additional","affiliation":[{"name":"From the Baylor Heart and Vascular Institute (W.C.R., T.J.V., J.M.K.) and the Departments of Pathology (W.C.R.), Internal Medicine (Division of Cardiology) (W.C.R.), and Cardiothoracic Surgery (R.F.H., A.C.H., G.J.M., B.L.H.), and Institute for Health Care Research and Improvement (G.F.), Baylor Health Care System, Baylor University Medical Center, Dallas, TX; and the Department of Statistical Science (G.F.), Southern Methodist University, Dallas, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory John","family":"Matter","sequence":"additional","affiliation":[{"name":"From the Baylor Heart and Vascular Institute (W.C.R., T.J.V., J.M.K.) and the Departments of Pathology (W.C.R.), Internal Medicine (Division of Cardiology) (W.C.R.), and Cardiothoracic Surgery (R.F.H., A.C.H., G.J.M., B.L.H.), and Institute for Health Care Research and Improvement (G.F.), Baylor Health Care System, Baylor University Medical Center, Dallas, TX; and the Department of Statistical Science (G.F.), Southern Methodist University, Dallas, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baron Lloyd","family":"Hamman","sequence":"additional","affiliation":[{"name":"From the Baylor Heart and Vascular Institute (W.C.R., T.J.V., J.M.K.) and the Departments of Pathology (W.C.R.), Internal Medicine (Division of Cardiology) (W.C.R.), and Cardiothoracic Surgery (R.F.H., A.C.H., G.J.M., B.L.H.), and Institute for Health Care Research and Improvement (G.F.), Baylor Health Care System, Baylor University Medical Center, Dallas, TX; and the Department of Statistical Science (G.F.), Southern Methodist University, Dallas, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(91)90544-U"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(92)90479-7"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.82.1.19"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.102.suppl_3.III-35"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.atv.0000055441.28842.0a"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(03)00462-4"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(03)00480-6"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2004.07.130"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2006.12.006"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.108.795401"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(99)00439-7"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(01)03236-2"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(03)00568-X"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000141593.05085.87"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2004.07.009"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2006.10.086"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.08.084"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2003.07.018"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000155623.48408.c5"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1159\/000095912"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(70)90761-7"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(82)90650-0"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(77)80004-0"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2009.06.071"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.99.16.2138"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(99)70002-4"},{"key":"e_1_3_3_28_2","first-page":"1233","article-title":"Aortic medial changes associated with bicuspid aortic valve: myth or reality?","volume":"15","author":"Parai JL","year":"1999","unstructured":"Parai JL, Masters RG, Walley VM, Stinson WA, Veinot JP . 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