Aortic Dissection Incidence Higher in Individuals With BAV

Incidence low but significantly higher in patients with bicuspid aortic valves than in general population

TUESDAY, Sept. 13 (HealthDay News) -- Aortic dissection incidence is higher in individuals with bicuspid aortic valves (BAVs) than in the general population, according to a study published in the Sept. 14 issue of the Journal of the American Medical Association.

Hector I. Michelena, M.D., from the Mayo Clinic in Rochester, Minn., and colleagues investigated the incidence of aortic complications of BAV in a community cohort of 416 patients diagnosed with BAV and in the general population. Residents of Olmsted County, Minn., with BAV confirmed on echocardiography were followed up from 1980 to 1999. Incidences of aortic complications were investigated in those with previously undiagnosed bicuspid valves. The last follow-up was in 2008 to 2009. The main outcome measures were thoracic aortic dissection, ascending aortic aneurysm, and aortic surgery.

The investigators identified aortic dissection in two of the 416 BAV patients after a mean follow-up of 16 years, an incidence of 3.1 cases per 10,000 patient-years and an age-adjusted relative-risk of 8.4 compared to the general county population. At baseline, patients ≥50 years and those with aortic aneurysms had aortic dissection incidences of 17.4 and 44.9 cases per 10,000 patient-years, respectively. Another two cases of aortic dissection occurred in the group with previously undiagnosed BAVs; the estimated aortic dissection incidence in bicuspid valve patients regardless of diagnosis was similar to the diagnosed cohort.

"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 authors write.

Two authors disclosed financial ties to the biomedical device industry.

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