Abstract 17792: Relation of Complications to Phenotypic Characteristics in Bicuspid Aortic Valve Disease: A Single Center Experience
Background: A congenital bicuspid aortic valve (BAV) is the commonest cardiac defect, occurring in 0.5-2% of the general population. It is often associated with cardiac events such as; valvular dysfunction, vascular abnormalities, and endocarditis. The aim of present study was to investigate demographic , genotyphic characteristics, and valvular and vascular involvement of BAV patients diagnosed and managed in a tertiary center.
Methods: 242 patients with BAV diagnosed by transthoracic (TTE) and transesophageal echocardiography (TOE) in our institution were assessed. All measurements were made according to the American Society of Echocardiography guidelines. The diagnosis of BAV was based on imaging of the aortic valve demonstrating only 2 valve leaflets, with or without raphe, in the parasternal short axis. Cardiovascular risk factors, valvular disease ( stenosis and/or regurgitation) and vascular (dilatation, anuerysm formation) involvement were assessed.
Results: Two hundred and forty two patients were diagnosed with BAV during a period of 10 years. The mean total follow-up was 43.2 months (median 35 range, 12 to 134 months). Mean age was 39.9 ± 13.2. Onehundred and seventy six (72.7%) patients were male. Fiftyfive ( 22.7%) patients had hypertension, 25 (10.3%) had hyperlipidemia, 14 (5.8%) had diabetes mellitus, 17 (7%) had family history of coronary artery disease and 25 (10.3%) smoked. Type 1, 2 and 3 leaflet morphology was seen in 165 (68.1%), 74 ( 30.7% ) and in 3 (1.2%) patients, respectively. The mean aortic root, ascending aorta and aortic arch diameter were 3.69±0.47cm, 3.95±0.66 cm. and 2.73±0.5 cm, respectively. At baseline analysis 99 patients had dilated ascending aorta, 30 (12.3%) had moderate to severe aortic stenosis and 45 (18.5%) had moderate to severe aortic regurgitation. Patients with dilatation of the aorta were older ( 44.6±11.5 vs 37.4±13.6; p<0.001) and were more likely to have hypertension (p<0.01). Gender , the other cardiovascular risk factors and leaflet morphology phenotype were not significantly related to dilatation. Leaflet morphologic phenotype was not associated to valvular stenosis or regurgitation. In conclusion, dilatation of ascending aorta in BAV disease seems to be ralated to age and hypertension.
- © 2013 by American Heart Association, Inc.