Bicuspid Aortic Valve Disease with Early-Onset Complications: Characteristics and Aortic Outcomes

Author:

Selbst Maximilian A.1ORCID,Ward Colin R.1,Svetgoff Megan L.1,Michelena Hector I.2,Sabate-Rotes Anna3ORCID,De Backer Julie4ORCID,Mosquera Laura Muiño4,Yetman Anji T.5,Bissell Malenka M.6,Andreassi Maria Grazia7ORCID,Foffa Ilenia7ORCID,Hui Dawn S.8,Caffarelli Anthony9,Kim Yuli Y.10ORCID,Guo Dongchuan11ORCID,Citro Rodolfo12ORCID,De Marco Margot13ORCID,Tretter Justin T.14,Morris Shaine A.15ORCID,McBride Kim L.16,Body Simon C.17ORCID,Prakash Siddharth K.11ORCID

Affiliation:

1. John P and Kathrine G McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX 77030, USA

2. Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USA

3. Facultad de Medicina, Hospital Vall d’Hebron, Universidad Autònoma Barcelona, 08193 Barcelona, Spain

4. Center for Medical Genetics, Ghent University, B-9000 Ghent, Belgium

5. Division of Pediatric Cardiology, University of Nebraska Medical Center, Omaha, NE 68198, USA

6. Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds LS2 9JT, UK

7. Consiglio Nazionale delle Richerche (CNR), Instituto di Fisiologia Clinica, 56124 Pisa, Italy

8. Department of Cardiothoracic Surgery, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA

9. Hoag Hospital Newport Beach, Newport Beach, CA 92663, USA

10. Division of Cardiovascular Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA

11. Department of Internal Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX 77030, USA

12. Department of Medicine and Health Sciences V. Tiberio, University of Molise, Responsible Research Hospital, 86100 Campobasso, Italy

13. Department of Medicine, Surgery and Dentistry, University of Salerno, 84084 Baronissi, Italy

14. Department of Pediatric Cardiology, Cleveland Clinic, Cleveland, OH 44195, USA

15. Division of Pediatric Cardiology, Baylor College of Medicine, Houston, TX 77030, USA

16. Department of Medical Genetics, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada

17. Department of Anesthesiology, Boston University School of Medicine, Boston, MA 02215, USA

Abstract

Bicuspid aortic valve (BAV) is the most common congenital heart malformation in adults, but it can also cause childhood-onset complications. The presentation and clinical course of young adults who present due to BAV complications are relatively uncharacterized. In a multicenter study, we found that young people who experience significant complications related to BAV disease before age 30 are distinguished from the majority of BAV cases that manifest after age 50 by a relatively severe clinical course, with higher rates of surgical interventions, more frequent second interventions, and a greater burden of congenital heart malformations. These observations highlight the need for prompt recognition, regular lifelong surveillance, and targeted interventions to address the significant health burdens of patients with early-onset BAV complications.

Publisher

MDPI AG

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