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Published on: December 11, 2017

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
PubMed

Insights

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.
Abstract

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