Sex-specific aortic root anatomy in patients with bicuspid aortic valve undergoing TAVR in a Chinese cohort

OBJECTIVES: The aim of this study is to investigate the sex-specific aortic root anatomy in patients with bicuspid aortic valve (BAV). PATIENTS AND METHODS: This retrospective study includes 73 consecutive patients with BAV who underwent CT evaluation before transcatheter aortic valve replacement (TAVR) between July 2013 and April 2017 in the Second Affiliated Hospital of Zhejiang University. RESULT: The size of the annulus, diameter and height of the sinotubular junction (STJ), height of the coronary artery ostia, and dimension of the aorta were measured. Women had significantly smaller annulus parameters (mean diameter: 23.4 ± 1.8 vs. 26.1 ± 2.1 mm; area: 425.3 ± 59.4 vs. 527.4 ± 84.6 mm(2); perimeter: 74.3 ± 5.2 vs. 83.2 ± 6.4 mm), and STJ diameter (29.7 ± 3.1 vs. 32.6 ± 4.5 mm) than men (p < 0.01 for all), even after adjustment for their smaller body surface area (BSA). Dimension of aorta and height of right coronary artery were also significantly smaller in women, although not when indexing for the BSA. The left ventricular ejection fraction of women is significantly higher than that of men before discharge (60.2 ± 9.7% vs. 53.7 ± 13.6%, p = 0.01). There were no differences between women and men in the all-cause 30-day and 1‑year mortality. CONCLUSION: Women with BAV had smaller annulus and STJ diameter after indexing for BSA, reflecting a sex-specific difference. There were no differences in 30-day and 1‑year mortality between the two groups. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00059-018-4740-0) contains supplementary material, which is available to authorized users.