Bicuspid Aortic Valve Increases Risk for Aortic Dissection

The absolute risk is low but much higher than in the general population, warranting heightened vigilance and aggressive treatment of aortic aneurysm in these patients.

Bicuspid aortic valve (BAV), the most common congenital cardiac abnormality, has been associated in some — but not all — studies with an increased risk for aortic dissection. In this community-based cohort study, investigators identified 416 patients with definite BAV (mean age at diagnosis, 35 years; 69% men) from 41,687 echocardiograms performed in residents of Olmsted County, MN, between 1980 and 1999. At baseline, aortic regurgitation and stenosis were present in 59% and 23% of patients, respectively, and mean maximum ascending aortic diameter was 34 mm. Follow-up duration was 20 years or until 2008–2009 (mean, 16 years).

During follow-up, only 2 patients had aortic dissection (25-year risk, 0.5%; adjusted risk relative to the general po…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI