Word count: 3750 words
Correspondence to :
Prashanth Vallabhajosyula, 330 Cedar Street, BB204,
New Haven, CT 06510 USA.
Phone; 203-785-6214, fax; 203-785-3346,
Email; prashanth.vallabhajosyula@yale.edu
ABSTRACTObjective: Reports of prevalence and clinical significance of
bicuspid aortic valve (BAV) disease are variable. We assessed our
institutional echocardiography (ECHO) database to understand the
reported prevalence of BAV and its potential association with thoracic
aortic aneurysm disease (TAAD).
Methods: All ECHOs of adult patients (>18 years)
performed at a single institution between calendar year 2013 to 2018
were reviewed. BAV patients were categorized by age group (Young
age:18-39 years; Middle age:40-65 years; Old age: >65years)
to assess for aortic valvulopathy and TAAD. Logistic regression analysis
was performed to understand association of BAV with TAAD.
Results: Of 48,503 unique patient ECHOs, 245 (0.51%)
described a diagnosis of BAV, with 93(40%) concomitant TAAD. Increased
association with endocarditis (p=0.01) and severe aortic insufficiency
(p=0.005) was seen in the Young group. Ascending aortic diameter was
significantly higher in the Middle compared to the Young group
(p<0.001), but similar to Old group. On multivariable
regression, BSA(OR=7.31(2.27-23.57)) and age (OR=1.02(1.00-1.04)), but
not BAV dysfunction (OR1.07(0.51-2.26)) were associated with TAAD.
Conclusions: In this large cross-sectional ECHO study,
reported BAV prevalence was 0.51%. We found high association of BAV
with concomitant TAAD especially in patients greater than 40 years of
age. This suggests that more frequent aortic surveillance may be
warranted in the middle and old age BAV subjects.
Abstract words count: 210