Valvular & structural heart diseaseCohort study
Bicuspid aortic valve: long-term morbidity and mortality
- Retrospective cohort study
- community-based
- consecutive patients
Authors' conclusion
The BAV condition exhibits a high lifetime morbidity burden where valvulo-aortopathy is close to unavoidable by age 90. The lifetime incidence of infective endocarditis is higher than that of aortic dissection. The most common BAV clinical presentation is the typical valvulo-aortopathy with preserved expected long-term survival, while the complex valvulo-aortopathy presentation incurs higher mortality.
Study context
- Population
- Olmsted County (Minnesota) residents with echocardiographic diagnosis of bicuspid aortic valve (BAV), 1980–2009525 adult, 127 paediatric
- Participants
- 652 participants
- Exposure
- Typical vs complex valvulo-aortopathy; survival vs age-sex-matched Minnesota population
- Typical valvulo-aortopathyn = 562
- Complex valvulo-aortopathyn = 90
- Outcome
- Lifetime morbidity and long-term survival
- Follow-up
- Median 19.1 (12.9-25.8) years
Main finding
As reported in the abstract
Cumulative lifetime morbidity (birth to age 90) and survival
Relative excess mortality risk
2.25
95% CI 1.21–4.19
P = 0.01
- Total cumulative lifetime morbidity burden (birth to age 90)
- 86% (95% CI 82.5-89.7)
- ≥ moderate AS or regurgitation
- 80.3%
- Aortic valve surgery
- 68.5%
- Aortic aneurysm ≥45 mm or z-score ≥3
- 75.4%
- Aorta surgery
- 27%
- Infective endocarditis
- 6%
- Aortic dissection
- 1.6%
Observational data: associations, not effects.
Original publication
Bicuspid aortic valve: long-term morbidity and mortality. Eur Heart J. Published 23 August 2023. doi:10.1093/eurheartj/ehad477
Summarised from the published abstract; every number is checked against it