Abstract 20580: Type of Cusp Fusion in Patients With Bicuspid Aortic Valves is not associated With the Progression of Aortic Regurgitation or Aortic Stenosis, but is related to Dilation of the Ascending Aorta
Introduction: Bicuspid aortic valves (BAV) are associated with aortic regurgitation (AR), aortic stenosis (AS), and aortic dilation.
Hypothesis: Does the type of cusp fusion impact the development of valvular dysfunction and aortic disease in patients with BAV?
Methods: In a large retrospective cohort study with long term follow up, 259 patients (mean age 47.7±13.5 yrs) had BAV with at least 2 transthoracic echocardiograms separated by a minimum of 1 year (mean 4.97±2.48 yrs). Severity of AS was graded based on valve area. AR was classified as mild, moderate, or severe using color flow Doppler. Rate of change of the ascending aorta among groups was analyzed using analysis of variance (ANOVA). Multivariate logistic regression was used to analyze progression of AR and AS.
Results: The majority of patients had right and left (R-L) cusp fusion (67%), while 21% had right and non-coronary (R-N) cusp fusion, and 8% had bicommissural valves. Cusp fusion was indeterminate in 9 patients, but confirmed to be BAV at surgery. The progression of AR and AS among patients with R-L fusion was not significantly different from patients with R-N fusion and bicommissural valves. When comparing the rate of change of ascending aortic size, there was a significant difference between groups (p = 0.042). Patients with R-N fusion had a faster rate of change than patients with R-L fusion (p=0.015). See Table 1.
Conclusion: In patients with BAV, type of cusp fusion was not associated with the progression of AR or AS in this large cohort. Due to the rapid increase in ascending aortic size in patients with R-N fusion, more frequent imaging to assess aortic dilation may need to be considered in this specific population.
Author Disclosures: R. Dallasen: None. A. Ogunsua: None. M. Parker: None. B. Gentile: None. J. Dickey: None. A. Kundu: None. S. Lakshmanan: None. N. Shah: None. L. Pape: None.
- © 2016 by American Heart Association, Inc.