Abstract 15913: Characteristics of Acute Aortic Dissection in Patients With Bicuspid Aortic Valve: Insights From the IRAD Registry
Background: Bicuspid aortic valve (BAV) is a congenital condition that predisposes patients to ascending aortic aneurysm and dissection. This study aims to characterize patients with acute aortic dissection (AAD) and BAV to improve our understanding of this aortic malformation.
Methods: We examined 3393 AAD patients enrolled in the International Registry of Acute Aortic Dissection. Demographic, morphological, and clinical characteristics as well as management type and outcomes were stratified by the presence or absence of BAV.
Results: Among 113 patients with BAV (3.3%), 93 (82.3%) presented with type A AAD while 20 (17.7%) had type B AAD. Compared to the non-BAV population, patients with BAV were younger (mean age: 53.6 ± 16.3 v. 63.5 ± 13.5 years; p<0.001), and more frequently presented at age<40 years (22.1% v. 4.9%;p<0.001). BAV patient histories revealed more known aortic aneurysms (25.5% v. 13.1%;p<.0001) and prior aortic valve replacement (14.7% v. 3.1%; p<0.001). Compared to the non-BAV population, AAD in BAV patients more frequently involved the aortic root (46.2% v. 34.7%; p=0.016) and/or arch vessels (41.6% v. 28.6%; p=0.014). Furthermore, these patients demonstrated less extension to the abdominal aorta (28.6% v. 44.6%, p=0.002). In addition, BAV subjects were more likely to present with larger a aortic dimension (Sinuses of Valsalva: 5.0 v.3.9 cm, p<0.001; ascending:5.3 v. 4.5 cm, p<0.001), and aortic valve insufficiency (52.1% v. 39.3%; p=0.013). Consequently, BAV patients more frequently underwent aortic valve (56.8% v. 21.7%; p<0.001) and/or root (66.7% v. 28.4%; p<0.001) replacement. Despite their younger age, BAV patients did not show superior 3-year post-admission survival rates (82.4% v. 89.1%; p=0.096)
Conclusions: AAD in patients with BAV presents with distinct morphological and clinical characteristics. These findings may expand our understanding of this congenital aortic malformation and improve therapeutic management.
- © 2013 by American Heart Association, Inc.