What is the risk of aortic dissection with bicuspid aortic valves?

January 01, 0001

What is the risk of aortic dissection with bicuspid aortic valves?

Bicuspid aortic valve are the most common congenital heart Defect and have been thought to be a frequent cause of aortic dissection. These US researchers performed a retrospective cohort study to determine the incidence of aortic complications in patients with bicuspid aortic valve in Olmsted County, Minnesota. Patients were followed up to 28 years.

The researchers found: "Aortic dissection occurred in 2 of 416 patients, incidence of 3.1 cases per 10,000 patient-years, age-adjusted relative-risk 8.4 compared with the county's general population. Aortic dissection incidences for patients 50 years or older at baseline and bearers of aortic aneurysms at baseline were 17.4 and 44.9 (cases per 10,000 patient- years, respectively... Of 384 patients without baseline aneurysms, 49 developed aneurysms at follow-up, incidence of 84.9 cases per 10 000 patient- years and an age-adjusted relative risk 86.2. The 25-year rate of aortic surgery was 25%.

The researchers concluded: "In the population of patients with BAV, the incidence of aortic dissection over a mean of 16 years of follow-up was low but significantly higher than in the general population."

The risk of aortic dissection in patients with bicuspid aortic valves may be lower than initially thought, but is still significantly higher than in the general population

For the full abstract, click here.

JAMA 306(10):1104-1112, 14 September 2011 © 2011 American Medical Association
Incidence of Aortic Complications in Patients With Bicuspid Aortic Valves. Hector I. Michelena, Amber D. Khanna, Douglas Mahoney, et al.

Category: K. Circulatory. Keywords: bicuspid, aortic valve, dissection, aorta, risk, retrospective cohort study, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 30 September 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

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