Aortic Dissection Rare in Pregnancy With Bicuspid AV

Few pregnant bicuspid aortic valve patients have aortic valve replacement, ascending aortic surgery

FRIDAY, Jan. 28 (HealthDay News) -- Aortic dissection is rare in women with bicuspid aortic valve (BAV) who are pregnant, according to a study published in the January issue of The American Journal of Cardiology.

Stephen H. McKellar, M.D., of the Mayo Clinic in Rochester, Minn., and colleagues searched an echocardiographic database of women who had been diagnosed with congenital BAV between 1980 and 1999. They reviewed medical records for end points of aortic valve replacement (AVR) and aortic dilatation, dissection, or surgery, and conducted a survey to determine obstetric history and further outcome.

The researchers identified 88 women with BAV, with total obstetric histories consisting of 216 pregnancies and 186 deliveries, and no aortic dissections. During a median of 12.3 years of follow-up, 24 patients had AVR, three had ascending aortic surgery, and seven had both. Pregnancy was not related to dilatation of the aorta, aorta surgery, or AVR. At echocardiographic diagnosis of BAV, 6 percent of patients had aortas more than 40 mm in diameter; of 60 patients with comparison echocardiograms at a median of 10.7 years of follow-up, 35 percent had aortas over 40 mm in diameter.

"Pregnancy is, in our view, reasonable to undertake if the aorta is ≤4.5 cm in diameter with rigorous blood pressure control and careful echocardiographic follow-up to identify any progressive aortic enlargement," the authors write.

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