Congenital heart diseaseRisk of Aortic Root or Ascending Aorta Complications in Patients With Bicuspid Aortic Valve With and Without Coarctation of the Aorta
Section snippets
Methods
Since December 1989, all patients ≥15 years old diagnosed with a congenital cardiac anomaly at La Paz University Hospital (Madrid, Spain) were referred to the Adult Congenital Heart Disease Unit and prospectively followed up. Until June 2006, 2,776 patients had been included in our database. In this cohort, we identified 631 patients with BAV diagnosed by 2-dimensional echocardiography or surgical inspection and without associated complex congenital heart disease, except for a ventricular
Results
The median patient age at presentation for the overall population was 32 years (interquartile range 18 to 51), and 68% (n = 425) were men. A total of 29 AACs were found (4.7%), including aortic root or AA dilation ≥55 mm in 20, type A aortic dissection in 7, and ruptured sinus of Valsalva or AA aneurysm in 2. Univariate and multivariate analyses (logistic regression) showed that only the co-existence of a COA was a significant discriminate factor for the primary end point (odds ratio 4.7, 95%
Discussion
The results of the present study have demonstrated that the incidence of aortic root or AACs in patients with isolated BAV, who did not present with these complications at clinical onset, is very low with long-term follow-up. However, patients with an associated COA were at an increased risk of a new aortic root or ascending aorta event. These data highlight the interaction among COA, BAV, and intrinsic disease of the aortic wall9 (Figure 3).
A ninefold increased risk of type A aortic dissection
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