Valvular & structural heart disease
Clinical Outcomes in Patients With Bicuspid Aortic Valves and Ascending Aorta ≥50 mm Under Surveillance
Authors' conclusion
In BAV patients with ascending aorta 50 to 54 mm under surveillance, AoD incidence is low and the overall rates of AoD and surgical mortality are similar, suggesting clinical equivalence between surgical and surveillance strategies.
Study context
- Population
- Adults with bicuspid aortic valve and ascending aorta ≥50 mm by TTE547 under surveillance
- Participants
- 875 adults
- Exposure
- Ascending aorta 50–54 mm vs ≥55 mm under surveillance
- 50 to 54 mmn = 496reference
- ≥55 mmn = 51
- Outcome
- Aortic dissection, aorta surgery, surgical mortality and all-cause death
- Follow-up
- Median 7.51 years
Methodological detailsmulticentre
- Multicentre
Main finding
As reported in the abstract
AoD in 50 to 54 mm under surveillance
Aortic dissection (AoD), 50 to 54 mm under surveillance
9/496
1.8%
AoD incidence, 50 to 54 mm under surveillance
0.4 cases per 100 person-years
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| All-cause death with ≥moderate AS (50 to 54 mm under surveillance) · aorta size not associated | 2.05 (1.32–3.20) | P = 0.001 | |
| 0.20.5125Hazard ratio (log scale) |
AoD rate, ≥55 mm under surveillance
- AoD rate in patients ≥55 mm under surveillance
- 5.9%
Surgical mortality, 50 to 54 mm under surveillance who underwent surgery
- Surgical mortality
- 5/266 (1.9%)
All-cause death, all 547 under surveillance
- Aorta size and ≥moderate AS both associated with all-cause death
- both P ≤ 0.027
Original publication
Clinical Outcomes in Patients With Bicuspid Aortic Valves and Ascending Aorta ≥50 mm Under Surveillance. JACC Adv. Published 22 September 2023. doi:10.
Summarised from the published abstract; every number is checked against it