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.