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Prevalence and predictors of intracranial aneurysms in patients with bicuspid aortic valve

Alexander C Egbe1, Ratnasari Padang1, Robert D Brown2

  • 1Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA.

Heart (British Cardiac Society)
|June 10, 2017
PubMed

Insights

Bicuspid aortic valve (BAV) patients have a higher risk of intracranial aneurysms (IA), especially those with coarctation of the aorta, female gender, or specific valve anatomy. The study found no new IA development during follow-up.

Area of Science:

  • Cardiovascular Medicine
  • Neurology
  • Radiology

Background:

  • Bicuspid aortic valve (BAV) is a common congenital heart defect.
  • Intracranial aneurysms (IA) are a serious cerebrovascular condition.
  • The association between BAV and IA requires further investigation.

Purpose of the Study:

  • To determine the prevalence of intracranial aneurysms (IA) in patients with bicuspid aortic valve (BAV).
  • To identify risk factors associated with IA in BAV patients.
  • To assess the outcomes of IA in this patient cohort.

Main Methods:

  • Retrospective review of 678 patients with BAV.
  • Brain MR angiography performed between 1994 and 2013.
  • Analysis of patient demographics, comorbidities (e.g., coarctation of the aorta), and IA presence and outcomes.

Main Results:

  • Intracranial aneurysm (IA) prevalence was 7.7% (52/678 patients).
  • IA prevalence was significantly higher in patients with coarctation of the aorta (12.9%) compared to those without (5.7%).
  • Female gender and right-left cusp fusion were identified as risk factors for IA in women without coarctation of the aorta.

Conclusions:

  • Bicuspid aortic valve (BAV) is associated with a higher prevalence of intracranial aneurysms (IA) than the general population.
  • The risk of IA in BAV patients is elevated in the presence of coarctation of the aorta, female gender, and right-left cusp fusion.
  • No new IA developed in patients without baseline IA during the imaging follow-up period.
Abstract

Keywords:
Bicuspid aortic valveCoarctation of aortaIntracranial aneurysmMagnetic resonance angiography

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