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.