Natural history and outcome of adults with bicuspid aortic-valve: A middle-aged French cohort of 541 patients - 06/01/20
Résumé |
Background |
No data are available on the natural history and outcomes of middle-aged European patients with bicuspid aortic-valve (BAV), as the only 2 large studies were conducted on young adults in Canada and north America.
Aims |
We aim to determine the frequency of cardiovascular events and to assess the survival relative to that of the general population in a large consecutive series of adults diagnosed with BAV in our echocardiographic laboratory according to the presence or the absence of a valvular and/or vascular surgical indication at the time of diagnosis.
Methods |
Between 2005 and 2017, 350patients without surgical indication (medical group, mean age 53years, 71% of men) and 191patients with surgical indication (surgical group, mean age 59, 71% of men) at baseline have been included. Median follow-up was 80 [32–115] months.
Results |
In the medical group, 34 deaths (9.7%) were recorded (10 cardiovascular-related). The 5-years and 10-years survival rate were respectively 93±1% and 88±2% with a relative survival of BAV patients compared to the age-and-sex matched population of 98.8%. Nine patients (2.6%) were diagnosed with infective endocarditis (IE) and no aortic dissection occurred. Aortic-valve and/or ascending aorta surgery was performed in 102patients (29%) during follow-up. In the surgical group, 12 deaths (6.3%) were recorded (5 cardiovascular-related). The 5-years and 10-years survival rate were respectively 97±1% and 90±3% with a relative survival of BAV patients compared to the age-and-sex matched population of 99.2%. Five patients (2.6%) were diagnosed with IE and no aortic dissection occurred.
Conclusion |
Survival rates were not lower than for the general population. The rate of IE was low and no aortic dissection occurred during follow-up. Middle-aged adults with BAV have a high likelihood of surgery on the aortic-valve and/or ascending aorta.
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Vol 12 - N° 1
P. 73-74 - janvier 2020 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.