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Prevalence of Bicuspid Aortic Valve and Associated Aneurysmal Pathology in Patients Undergoing Echocardiography
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  • Sameh Yousef,
  • saket singh,
  • Makoto Mori,
  • Clancy Mullan,
  • Cornell Brooks,
  • Roland Assi,
  • Arnar Geirsson,
  • Prashanth Vallabhajosyula
Sameh Yousef
Yale School of Medicine
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saket singh
Yale University School of Medicine
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Makoto Mori
Yale University School of Medicine
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Clancy Mullan
Yale School of Medicine
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Cornell Brooks
Yale School of Medicine
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Roland Assi
Yale University School of Medicine
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Arnar Geirsson
Yale University School of Medicine
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Prashanth Vallabhajosyula
Yale School of Medicine
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Abstract

Objective: 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.