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Bicuspid aortic valve: long-term morbidity and mortality.
Li-Tan Yang1,2, Zi Ye1, Muhammad Wajih Ullah1
1Department of Cardiovascular Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
European Heart Journal
|August 23, 2023
Summary
Bicuspid aortic valve (BAV) causes significant lifetime morbidity, with nearly all patients developing valvulo-aortopathy by age 90. While typical BAV has normal survival, complex BAV is linked to increased mortality.
Area of Science:
- Cardiology
- Genetics
- Public Health
Background:
- Bicuspid aortic valve (BAV) is the most prevalent congenital heart defect.
- Lifetime morbidity and survival variations in BAV patient subgroups remain unclear.
Purpose of the Study:
- To evaluate the lifetime morbidity burden in BAV patients.
- To assess long-term survival rates across different BAV patient subgroups.
Main Methods:
- Retrospective cohort study of Olmsted County residents diagnosed with BAV between 1980-2009.
- Patients categorized into typical and complex valvulo-aortopathy groups.
- Long-term follow-up to assess morbidity and survival outcomes.
Main Results:
- High lifetime morbidity (86%) observed by age 90, with 80.3% progressing to moderate or severe aortic stenosis/regurgitation.
- Typical BAV patients (86% of cohort) showed survival comparable to the general population.
- Complex BAV patients (14% of cohort) exhibited significantly higher mortality (relative excess risk 2.25).
Conclusions:
- BAV leads to substantial lifetime morbidity, with valvulo-aortopathy being nearly universal.
- Typical BAV is associated with normal long-term survival.
- Complex BAV significantly increases mortality risk, highlighting the need for risk stratification.
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