{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T04:55:58Z","timestamp":1782881758836,"version":"3.54.5"},"reference-count":13,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,3,19]],"date-time":"2024-03-19T00:00:00Z","timestamp":1710806400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,3,19]],"date-time":"2024-03-19T00:00:00Z","timestamp":1710806400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Cardiothorac Surg"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>We investigated long-term outcomes, particularly later aorta operations and overall death in patients who underwent aortic valve replacement for bicuspid aortic valve without aortic surgery.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Between January 2002 and December 2022, 274 patients underwent aortic valve replacement for bicuspid aortic valve at our institution. Of them, 181 patients who did not undergo aortic surgery, in accordance with current guidelines, were analyzed retrospectively.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The median follow-up duration was 6.1 (2.0\u201310.6) years, and follow-up was completed in 97.8% of pateints. There were 3 patients (1.7%) who underwent later aorta operation during follow-up period. The cumulative later aorta operation rate at 10 years adjusting overall death as competing risk was 16.3%, and the estimated rates of freedom from overall death at 10 years was 83.7%. Fine-Gray competing risk regression model showed that aortic valve stenosis was only the predictor of later aorta operation (hazard ratio 8.477; <jats:italic>p<\/jats:italic>\u2009=\u20090.012). In multivariable Cox models, predictors of overall death were aortic valve stenosis (hazard ratio: 8.270, 95% confidence interval: 1.082\u201363.235; <jats:italic>p<\/jats:italic>\u2009=\u20090.042) and operation time (hazard ratio: 1.011, 95% confidence interval: 1.004\u20131.017; <jats:italic>p<\/jats:italic>\u2009=\u20090.002).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Patients with bicuspid aortic valve with ascending aortic diameter less than 45\u00a0mm are at low risk of later aorta operation after isolated aortic valve replacement.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13019-024-02638-6","type":"journal-article","created":{"date-parts":[[2024,3,19]],"date-time":"2024-03-19T07:02:43Z","timestamp":1710831763000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Later aorta operation after aortic valve replacement for bicuspid aortic valve"],"prefix":"10.1186","volume":"19","author":[{"given":"Kohei","family":"Hachiro","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noriyuki","family":"Takashima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoaki","family":"Suzuki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,3,19]]},"reference":[{"key":"2638_CR1","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1016\/j.jtcvs.2018.02.115","volume":"156","author":"MA Borger","year":"2018","unstructured":"Borger MA, Fedak PWM, Stephens EH, Gleason TG, Girdauskas E, Ikonomidis A, et al. The American Association for Thoracic Surgery consensus guidelines on bicuspid aortic valve related aortopathy: full online-only version. J Thorac Cardiovasc Surg. 2018;156:41\u201374.","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2638_CR2","doi-asserted-by":"publisher","first-page":"2873","DOI":"10.1093\/eurheartj\/ehu281","volume":"35","author":"R Erbel","year":"2014","unstructured":"Erbel R, Aboyans V, Boileau C, Bossone E, Bartolomeo RD, Eggebrecht H, et al. 2014 ESC guidelines on the diagnosis and treatment of aortic disease: document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. The Task Force for the diagnosis and treatment of aortic diseases of the European Society of Cardiology (ESC). Eur Heart J. 2014;35:2873\u2013926.","journal-title":"Eur Heart J"},{"key":"2638_CR3","doi-asserted-by":"publisher","first-page":"900","DOI":"10.1161\/01.CIR.0000027905.26586.E8","volume":"106","author":"PW Fedak","year":"2002","unstructured":"Fedak PW, Verma S, David TE, Leask RL, Weisel RD, Butany J. Clinical and pathological implications of a bicuspid aortic valve. Circulation. 2002;106:900\u20134.","journal-title":"Circulation"},{"key":"2638_CR4","doi-asserted-by":"publisher","first-page":"2789","DOI":"10.1016\/j.jacc.2009.12.068","volume":"55","author":"SC Siu","year":"2010","unstructured":"Siu SC, Silversides CK. Bicuspid aortic valve disease. J Am Coll Cardiol. 2010;55:2789\u2013800.","journal-title":"J Am Coll Cardiol"},{"key":"2638_CR5","doi-asserted-by":"publisher","first-page":"809","DOI":"10.1016\/j.ejcts.2011.01.001","volume":"39","author":"E Girdauskas","year":"2011","unstructured":"Girdauskas E, Borger MA, Secknus MA, Girdauskas G, Kuntze T. Is aortopathy in bicuspid aortic valve disease a congenital defect or a result of abnormal hemodynamics? A critical reappraisal of a one-sided argument. Eur J Cardiothorac Surg. 2011;39:809\u201314.","journal-title":"Eur J Cardiothorac Surg"},{"key":"2638_CR6","doi-asserted-by":"publisher","first-page":"880","DOI":"10.1161\/CIRCULATIONAHA.108.795401","volume":"119","author":"TM Tadros","year":"2009","unstructured":"Tadros TM, Klein MD, Shapira OM. Ascending aortic dilation associated with bicuspid aortic valve: pathophysiology, molecular biology, and clinical implications. Circulation. 2009;119:880\u201390.","journal-title":"Circulation"},{"key":"2638_CR7","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1161\/CIRCIMAGING.112.973370","volume":"5","author":"AJ Barker","year":"2012","unstructured":"Barker AJ, Markl M, Burk J, Lorenz R, Bock J, Bauer S, et al. Bicuspid aortic valve is associated with altered wall shear stress in the ascending aorta. Circ Cardiovasc Imaging. 2012;5:457\u201366.","journal-title":"Circ Cardiovasc Imaging"},{"key":"2638_CR8","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1148\/radiol.09091437","volume":"255","author":"MD Hope","year":"2010","unstructured":"Hope MD, Hope TA, Meadows AK, Ordovas KG, Urbania TH, Alley MT, et al. Bicuspid aortic valve: four-dimensional MR evaluating of ascending aorta systolic flow patterns. Radiology. 2010;255:53\u201361.","journal-title":"Radiology"},{"key":"2638_CR9","doi-asserted-by":"publisher","first-page":"797","DOI":"10.1016\/S0022-5223(03)00398-2","volume":"126","author":"PW Fedak","year":"2003","unstructured":"Fedak PW, de Sa MP, Verma S, Nili N, Kazemian P, Butany J, et al. Vascular matrix remodeling in patients with bicuspid aortic valve malformations: implications for aortic dilation. 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J Thorac Cardiovasc Surg. 2014;147:276\u201382.","journal-title":"J Thorac Cardiovasc Surg"}],"container-title":["Journal of Cardiothoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13019-024-02638-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13019-024-02638-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13019-024-02638-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,19]],"date-time":"2024-03-19T07:07:11Z","timestamp":1710832031000},"score":1,"resource":{"primary":{"URL":"https:\/\/cardiothoracicsurgery.biomedcentral.com\/articles\/10.1186\/s13019-024-02638-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,19]]},"references-count":13,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["2638"],"URL":"https:\/\/doi.org\/10.1186\/s13019-024-02638-6","relation":{},"ISSN":["1749-8090"],"issn-type":[{"value":"1749-8090","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,19]]},"assertion":[{"value":"25 October 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 March 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 March 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The procedures in this study were performed in accordance with the Declaration of Helsinki. The present study was approved by Shiga University of Medical Science (Reference number: R2022-218).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"All authors declare their full consent for publishing their article in Journal of Cardiothoracic Surgery.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that there is no conflict of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"144"}}