Conclusions
In conclusion, TAV and BAV asymptomatic patients with AS exhibit many
differences. Patients with AS have a high incidence of all-cause
mortality and aortic valve intervention, regardless of valve type. In
particular, patients with BAV present different clinical and
echocardiographic characteristics, with lower overall mortality and a
more advanced AS when requiring aortic valve intervention. On the other
side, patients with TAV have more frequently association with coronary
artery disease and are symptomatic with earlier stages of AS. Besides,
type of intervention is different between these two groups. In our
cohort, we identified Vmax and dimensionless index as independent
predictors of primary end-point in both groups, which led to
identification of group with a higher risk of major events.
These findings support that cardiologists should pay careful attention
to adult patients with BAV and AS who are not only at risk of
accelerated disease progression, but also adverse outcomes, and that
underlying valve morphology should be considered when managing patients
with AS.