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Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
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Incidence of aortic complications in patients with bicuspid aortic valves
Hector I Michelena1, Amber D Khanna, Douglas Mahoney
1Division of Cardiovascular Disease, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA. michelena.hector@mayo.edu
JAMA
|September 16, 2011
Summary
Patients with bicuspid aortic valve (BAV) have a low incidence of aortic dissection, but it is significantly higher than in the general population. Long-term data show an increased risk of aortic aneurysm and surgery in BAV patients.
Area of Science:
- Cardiology
- Genetics
- Public Health
Background:
- Bicuspid aortic valve (BAV) is the most common congenital heart defect.
- Long-term, population-based data on aortic complications in BAV patients are limited.
Purpose of the Study:
- To determine the incidence of aortic complications in patients with BAV.
- To compare these incidences with the general population.
Main Methods:
- Retrospective cohort study of Olmsted County residents diagnosed with BAV (1980-1999).
- Long-term follow-up (until 2008-2009) assessing thoracic aortic dissection, ascending aortic aneurysm, and aortic surgery.
- Inclusion of patients with diagnosed and undiagnosed BAV.
Main Results:
- Aortic dissection incidence in BAV patients was 3.1 per 10,000 patient-years, 8.4 times higher than the general population.
- Incidence of ascending aortic aneurysms was 84.9 per 10,000 patient-years, 86.2 times higher than the general population.
- The 25-year rate of aortic surgery was 25% in BAV patients.
Conclusions:
- The incidence of aortic dissection in BAV patients is low but significantly elevated compared to the general population.
- BAV patients face a substantially increased risk of developing aortic aneurysms and requiring aortic surgery.
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