We compared the long-term outcomes and difference in dilatation rates of the ascending aorta after aortic valve (AV) replacement (AVR) between bicuspid and tricuspid AV patients, and evaluated risk factors associated with ascending aorta dilatation and aortic events during the follow-up. Of 1,127 patients who underwent AVR from 1995 to 2015, 259 patients with a dilated ascending aorta (≥40 mm in diameter) were included. The patients were divided into those with bicuspid (group bicuspid aortic valve [BAV], n = 105) and with tricuspid (group tricuspid aortic valve [TAV], n = 154) AV, and a propensity score-matched analysis was performed to match 98 patients in each group. The differences in the dilation rate of the ascending aorta and long-term outcomes were analyzed. Risk factors for ascending aorta dilatation, mortality, and aortic events were identified. Follow-up was completed in 100% of patients with a median follow-up duration of 106.1 [68.8, 163.0] months. The early clinical outcomes and dilation rate of the ascending aorta were similar between the groups. Overall survivals up to 15 years postoperatively were similar between groups BAV and TAV (p = 0.223). Aortic events occurred in 6 patients (groups BAV vs TAV, 2 vs 4;p = 0.678). Preoperative ascending aorta diameter showed a linear relationship with the dilatation rate of ascending aorta (p <0.001) and was related to progressive aortic dilatation and aortic events (odds ratio: 1.25, p <0.001 and hazard ratio = 1.56, p <0.001, respectively). In conclusion, the long-term outcomes and ascending aorta dilatation rate were similar between the BAV and TAV patients up to 15 years after AVR. Bicuspid AV was not a risk factor of mortality or aortic events.

我们比较了三尖瓣和三尖瓣AV患者之间主动脉瓣置换（AVR）后升主动脉的长期结局和扩张率的差异，并评估了随访期间升主动脉扩张和主动脉事件相关的危险因素。在1995年至2015年间接受AVR的1,127例患者中，包括259例主动脉扩张（直径≥40 mm）。将患者分为二尖瓣（双尖瓣主动脉瓣[BAV]，n = 105）和三尖瓣（三尖瓣主动脉瓣[TAV]，n = 154）AV，并进行倾向评分匹配分析以匹配每组98例。分析升主动脉扩张率和长期结局的差异。升主动脉扩张，死亡，并确定了主动脉事件。100％的患者完成了随访，中位随访时间为106.1 [68.8，163.0]个月。两组之间早期临床结果和升主动脉扩张率相似。BAV组和TAV组之间术后15年的总生存率相似（p = 0.223）。6名患者发生了主动脉事件（BAV vs TAV，2 vs 4； p = 0.678）。术前升主动脉直径与升主动脉扩张率呈线性关系（p <0.001），并与进行性主动脉扩张和主动脉事件相关（几率分别为1.25，p <0.001和危险比= 1.56，p <0.001） ）。总之，BAV和TAV患者至AVR后15年的长期预后和升主动脉扩张率相似。