September 14th, 2011

Study Sheds Light on Consequences of Bicuspid Aortic Valve

Although bicuspid aortic valve (BAV) is the most frequently occurring congenital heart defect, little is known about the long-term prognosis of people with BAV. Now a study published in JAMA shows that although affected people have a low overall rate of aortic complications, their risk is nevertheless about 8 times greater than the risk of those without BAV.

Hector Michelena and colleagues retrospectively followed 416 BAV patients for 16 years. During that period, two patients had an aortic dissection, representing an incidence of 3.1 cases per 10,000 patient-years — more than 8 times the risk of the general population. Risk was higher in people 50 years of age or older (17.4  cases per 10,000 patient-years) and in people with aortic aneurysms at baseline (44.9 cases per 10,000 patient-years).

At baseline, 384 patients did not have an aneurysm. Some 49 went on to develop an aneurysm, representing an incidence of 84.9 cases per 10,000 patient-years — 86 times the risk of the general population. Overall, the 25-year rate of aortic surgery was 25%, and the rate of valve replacement was 53%.

The authors write that their findings “support current recommendations of electively repairing ascending aortic aneurysms and have implications for clinical and echocardiographic surveillance of … patient subsets.”

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