OBJECTIVE: To compare the clinical features of type A aortic dissection (AAD) in 
patients with Marfan syndrome (MFS) and bicuspid aortic valves (BAV).
METHODS: 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.
RESULTS: 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).
CONCLUSIONS: MFS and BAV represent unique subgroups of acute type A aortic 
dissection. BAV-associated dissection demonstrated strikingly higher 
postoperative mortality in our study population.