In:
Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 142, No. Suppl_3 ( 2020-11-17)
Abstract:
Introduction: Patients with bicuspid aortic valve (BAV) are at increased risk of developing severe aortic valve disease and aortopathy at an early age. We therefore performed a retrospective study to describe all patients diagnosed with BAV in an entire region of Denmark. Methods: We included patients≥18 years old with BAV, who had a transthoracic echocardiography (TTE) at our hospital before May 2020, and through electronic health records and our echocardiography database, we achieved baseline data. Results: A total of 545 patients with BAV (74.1% men) were identified. At the time of BAV diagnosis the median age was 54 years (IQR 42-62), and the causes for referral to TTE were primarily chest discomfort (21.1%), dyspnea (17.6%), or a newly discovered murmur (40.0%). Upon diagnosis 19.3% of the patients had an aortic valve area (AVA) 〈 1,0 cm 2 , 2.4% had severe aortic regurgitation and the majority (84.0%) had normal left ventricular ejection fraction. The ascending aorta was dilated in 51.9% of the patients while aortic coarctation was found in 5.1% of all patients. According to Sievers BAV classification 24.4% (N=133) had Type 0, 58.7% (N=320) had Type 1 left/right(L/R) fusion, 10.6% (N=58) had Type 1 right/noncoronary (R/N) fusion, 2.6% (N=14) had Type 1 left/noncoronary (L/N) fusion and 2.2% (N=12) had Type 2. Coexisting diabetes mellitus (10.1%), ischemic heart disease (13.2%) and chronic obstructive pulmonary disease (10.1%) was low, whereas hypertension was frequent (47.9%). The majority had sinus rhythm (75.6%) and normal eGFR (84.4%). Surgery was performed in 37.3% (N=203) of all patients and primarily due to aortic valve stenosis (N=172, 84.7%). Surgery was performed in a higher frequency of patients with Sievers Type 1 L/N fusion (N=9, 4.4%; 64.3% of all Type 1 L/N) and Type 2 (N=10, 4.9%, 83.3% of all Type 2) and lowest in patients with Sievers Type 0 (N=35, 17.2%; 26.3% of all Type 0). However, likelihood of surgery was only significantly different between patients with BAV Type 2 and Type 1 L/R (OR 14.21 (2.83-71.35). Conclusion: In this cohort of patients with BAV a higher fraction of patients with BAV type 1 L/N and BAV type 2 required valve replacement compared with particularly BAV type 0 suggesting important differences according to BAV subtype.
Type of Medium:
Online Resource
ISSN:
0009-7322
,
1524-4539
DOI:
10.1161/circ.142.suppl_3.15609
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2020
detail.hit.zdb_id:
1466401-X
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