Clinical Outcomes of Adults With Bicuspid Aortic Valve: A European Perspective

Objective: To describe the clinical history of patients with a wide age range diagnosed with bicuspid aortic valve (BAV) and no surgical indication and to evaluate the long-term outcome of patients with BAV referred for elective surgery. Patients and Methods: Between 2005 and 2017, 350 consecutive patients with no surgical indication (surveillance group, mean age 53 +/- 16, 71% men) and 191 with a surgical indication (surgical group, mean age 59 +/- 13, 71% men) were prospectively included. Median follow-up was 80 (32 to 115) months. Results: In the surveillance group, the 5-year and 10-year survival rates were 93 +/- 1% and 89 +/- 2%, respectively, with a relative survival of patients with BAV compared with an age- and sex-matched control population of 98.7%. During follow-up, the cumulative 10-year incidence of aortic valve and aorta surgery was high; of 35 +/- 4%, the incidence of native valve infective endocarditis (IE) of 0.2% per patient-year, and no cases of aortic dissection were observed. In the surgical group, the 5-year and 10-year survival rates were 97 +/- 1% and 89 +/- 3%, respectively, with a relative survival of 99.4% compared with the general population. The incidence of IE was 0.4% per patient-year, and no cases of aortic dissection were observed. Conclusion: This regional cohort shows that the 10-year survival rates of patients with BAV and a wide age range, but mostly middle-aged adults, were similar to those of the general population with a very low rate of complications. Adherence to prophylactic surgical indications and younger age might have contributed to this lack of difference. (C) 2020 Mayo Foundation for Medical Education and Research

Automated summary

This study describes the clinical history of patients with BAV across different age groups and evaluates the long-term outcomes of patients referred for surgery. The results showed high survival rates in both the surveillance and surgical groups, with low incidences of complications.