Introduction
Bicuspid aortic valve (BAV) is the most common congenital heart defect, affecting 1-2% of the population worldwide. Aortic valve dysfunction due to calcific aortic valve stenosis (AS) is the most common complication. Patients with BAV represent a significant proportion of adults with severe aortic stenosis (AS) requiring aortic valve replacement.1
Even though BAV is a frequent disease, few longitudinal data are available on asymptomatic patients with AS compared to patients with tricuspid aortic valve (TAV). 2,3 The progression of AS in both phenotypes shares a common disease process of inflammation, calcium deposition, and ossification, however, patient charachteristics and evolution have differences that should be evaluated.4–7 Previous studies have shown that AS severity progress slowly over time in patients with BAV, but they have included young adults with BAV, most of them without significant aortic valve dysfunction.8–10 But according to recent evidence, it seems possible that when calcification proccess begins, patients with BAV will show a higher rate of progression and of aortic valve intervention requirement. 2,3,11 This discordance reflects the need of further research on this topic.
To answer these uncertainties, we conducted a retrospective cohort study comparing patients with AS according valve phenotype (BAV vs. TAV). We assessed baseline clinical and echocardiographic charachteristics. We aimed to study the impact of the aortic valve phenotype (i.e. BAV vs. TAV) on major cardiovascular outcomes.