Turkiye Klinikleri Cardiovascular Sciences

.: ORIGINAL RESEARCH
The Frequency of Bicuspid Aortic Valve in Healthy Young Adults Who Applied to the Health Board: A Tertiary Centre Experience: Retrospective Study
Sağlık Kuruluna Başvuran Sağlıklı Genç Erişkinlerde Biküspit Aort Kapak Sıklığı: Üçüncül Merkez Deneyimi: Retrospektif Çalışma
Ersan OFLARa , Dilay KARABULUTa , Abdulcelil Sait ERTUĞRULa , Cennet YILDIZa , İbrahim Faruk AKTÜRKa , Fatma Nihan TURHAN ÇAĞLARa , Alparslan ŞAHİNa
aClinic of Cardiology, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Türkiye
Turkiye Klinikleri J Cardiovasc Sci. 2023;35(1):8-12
doi: 10.5336/cardiosci.2022-93768
Article Language: EN
Full Text
ABSTRACT
Objective: Bicuspid aortic valve (BAV), which is the one of the most common congenital heart malformation and seen approximately 1-2% of the general population. It has been shown that BAV is associated aortic valve dysfunction (aortic stenosis, aortic regurgitation or both) and increased risk for bacterial endocarditis from adult to the advanced ages. In this study, we aimed to determine the frequency of BAV disease in the asymptomatic young population who is applied to the health board. Material and Methods: 5,490 subjects who were consulted to the cardiology outpatient by health board were systematically analyzed from our hospital database system and 15 patients with BAV were identified. The frequency of BAV and aortic valve measurments were recorded. Patients with previous aortic valve intervention were excluded from the study. Results: Fifteen patients with BAV were identified (0.3%), all patients were newly diagnosed during screening at the health board. Mean age of the BAV subjects was 23.4±2.45 years. Two of them were female (13.3%) and thirteen of them (86.7%) were male. Aortic insufficiency was the most common pathology, mild in 11 (73.3%), and moderate in 2 (13.3%) cases. Only 2 (13.3%) patients had aortic dilatation. Aortic stenosis was not detected. Conclusion: Prevalence of BAV in asymptomatic young adults was lower than the literature.

Keywords: Bicuspid aortic valve disease; aortic valve stenosis; aortic valve insufficiency
ÖZET
Amaç: Biküspit aort kapak (BAK) en sık görülen konjenital kalp hastalıklarından biridir ve genel popülasyonda %1-2 oranında görülür. BAK'ın yetişkinlikten ilerleyen yaşlara doğru aort kapak disfonksiyonu (aort stenozu, aort yetersizliği veya her ikisi) ve artmış infektif endokardit riski ile birlikte olduğu gösterilmiştir. Bu çalışmada, sağlık kuruluna başvuran asemptomatik genç erişkinlerde BAK sıklığını araştırmayı amaçladık. Gereç ve Yöntemler: Kardiyoloji polikliniğine sağlık kurulu muayenesi amacı ile başvuran 5.490 hastanın verisi tarandı ve 15 BAK hastası tespit edildi. BAK sıklığı ve aort kapak ölçümleri kaydedildi. Daha önceden aort kapak müdahalesi geçiren hastalar çalışmadan dışlandı. Bulgular: Sağlık kuruluna başvuran hastaların 15'inde BAK (%0,3) saptandı. Bu hastaların hepsi yeni teşhis edilen hastalardı. Hastaların ortalama yaşı 23,4±2,45 yıl idi. Hastaların 2'si (%13,3) kadın, 13'ü (%86,7) erkekti. En sık patoloji aort yetersizliği idi ve 11 (%73,3) hastada hafif, 2 (%13,3) hastada orta derecede saptandı. İki (%13,3) hastada aort genişlemesi saptandı. Aort darlığı hiçbir hastada saptanmadı. Sonuç: BAK prevalansı asemptomatik genç kişilerde literatürde belirtilen orandan daha düşük bulunmuştur.

Anahtar Kelimeler: Biküspit aort kapak hastalığı; aort kapak stenozu; aort kapağı yetersizliği
REFERENCES:
  1. Roberts WC. The structure of the aortic valve in clinically isolated aortic stenosis: an autopsy study of 162 patients over 15 years of age. Circulation. 1970;42(1):91-7. [Crossref]  [PubMed] 
  2. Ward C. Clinical significance of the bicuspid aortic valve. Heart. 2000;83(1):81-5. [Crossref]  [PubMed]  [PMC] 
  3. Aydin A, Desai N, Bernhardt AM, Treede H, Detter C, Sheikhzadeh S, et al. Ascending aortic aneurysm and aortic valve dysfunction in bicuspid aortic valve disease. Int J Cardiol. 2013;164(3):301-5. [Crossref]  [PubMed] 
  4. Kong WK, Delgado V, Poh KK, Regeer MV, Ng AC, McCormack L, et al. Prognostic implications of raphe in bicuspid aortic valve anatomy. JAMA Cardiol. 2017;2(3):285-92. [Crossref]  [PubMed] 
  5. Masri A, Kalahasti V, Alkharabsheh S, Svensson LG, Sabik JF, Roselli EE, et al. Characteristics and long-term outcomes of contemporary patients with bicuspid aortic valves. J Thorac Cardiovasc Surg. 2016;151(6):1650-9.e1. [Crossref]  [PubMed] 
  6. Michelena HI, Khanna AD, Mahoney D, Margaryan E, Topilsky Y, Suri RM, et al. Incidence of aortic complications in patients with bicuspid aortic valves. JAMA. 2011;306(10):1104-12. [Crossref]  [PubMed] 
  7. Fernandes SM, Sanders SP, Khairy P, Jenkins KJ, Gauvreau K, Lang P, et al. Morphology of bicuspid aortic valve in children and adolescents. J Am Coll Cardiol. 2004;44(8):1648-51. [Crossref]  [PubMed] 
  8. Michelena HI, Desjardins VA, Avierinos JF, Russo A, Nkomo VT, Sundt TM, et al. Natural history of asymptomatic patients with normally functioning or minimally dysfunctional bicuspid aortic valve in the community. Circulation. 2008;117(21):2776-84. [Crossref]  [PubMed]  [PMC] 
  9. Tzemos N, Therrien J, Yip J, Thanassoulis G, Tremblay S, Jamorski MT, et al. Outcomes in adults with bicuspid aortic valves. JAMA. 2008;300(11):1317-25. [Crossref]  [PubMed] 
  10. Tribouilloy C, Rusinaru D, Sorel C, Thuny F, Casalta JP, Riberi A, et al. Clinical characteristics and outcome of infective endocarditis in adults with bicuspid aortic valves: a multicentre observational study. Heart. 2010;96(21):1723-9. [Crossref]  [PubMed] 
  11. Mitchell C, Rahko PS, Blauwet LA, Canaday B, Finstuen JA, Foster MC, et al. Guidelines for performing a comprehensive transthoracic echocardiographic examination in adults: recommendations from the American Society of Echocardiography. J Am Soc Echocardiogr. 2019;32(1):1-64. [Crossref]  [PubMed] 
  12. Liu T, Xie M, Lv Q, Li Y, Fang L, Zhang L, et al. Bicuspid aortic valve: an update in morphology, genetics, biomarker, complications, imaging diagnosis and treatment. Front Physiol. 2019;9:1921. [Crossref]  [PubMed]  [PMC] 
  13. Hahn RT, Roman MJ, Mogtader AH, Devereux RB. Association of aortic dilation with regurgitant, stenotic and functionally normal bicuspid aortic valves. J Am Coll Cardiol. 1992;19(2):283-8. [Crossref]  [PubMed] 
  14. Nistri S, Sorbo MD, Marin M, Palisi M, Scognamiglio R, Thiene G. Aortic root dilatation in young men with normally functioning bicuspid aortic valves. Heart. 1999;82(1):19-22. [Crossref]  [PubMed]  [PMC] 
  15. Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP 3rd, Guyton RA, et al; ACC/AHA Task Force Members. 2014 AHA/ACC Guideline for the management of patients with valvular heart disease: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014;129(23):2440-92. Erratum in: Circulation. 2014;129(23):e650. [Crossref]  [PubMed] 
  16. Sievers HH, Schmidtke C. A classification system for the bicuspid aortic valve from 304 surgical specimens. J Thorac Cardiovasc Surg. 2007;133(5):1226-33. [Crossref]  [PubMed] 
  17. Niwa K, Perloff JK, Bhuta SM, Laks H, Drinkwater DC, Child JS, et al. Structural abnormalities of great arterial walls in congenital heart disease: light and electron microscopic analyses. Circulation. 2001;103(3):393-400. [Crossref]  [PubMed] 
  18. Basso C, Boschello M, Perrone C, Mecenero A, Cera A, Bicego D, et al. An echocardiographic survey of primary school children for bicuspid aortic valve. Am J Cardiol. 2004;93(5):661-3. [Crossref]  [PubMed] 
  19. Siu SC, Silversides CK. Bicuspid aortic valve disease. J Am Coll Cardiol. 2010;55(25):2789-800. [Crossref]  [PubMed] 
  20. Nistri S, Basso C, Marzari C, Mormino P, Thiene G. Frequency of bicuspid aortic valve in young male conscripts by echocardiogram. Am J Cardiol. 2005;96(5):718-21. [Crossref]  [PubMed] 
  21. Davies RR, Kaple RK, Mandapati D, Gallo A, Botta DM Jr, Elefteriades JA, et al. Natural history of ascending aortic aneurysms in the setting of an unreplaced bicuspid aortic valve. Ann Thorac Surg. 2007;83(4):1338-44. [Crossref]  [PubMed] 
  22. Nemer M, Gharibeh L. The hereditary basis of bicuspid aortic valve disease: a role for screening? Adv Genom Genet. 2014;2015(5):11‐7. [Crossref] 
  23. Friedman T, Mani A, Elefteriades JA. Bicuspid aortic valve: clinical approach and scientific review of a common clinical entity. Expert Rev Cardiovasc Ther. 2008;6(2):235-48. [Crossref]  [PubMed] 
  24. Habib G, Lancellotti P, Antunes MJ, Bongiorni MG, Casalta JP, Del Zotti F, et al; ESC Scientific Document Group. 2015 ESC Guidelines for the management of infective endocarditis: The Task Force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC). Endorsed by: European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM). Eur Heart J. 2015;36(44):3075-128. [Crossref]  [PubMed] 
  25. Duval X, Leport C. Prophylaxis of infective endocarditis: current tendencies, continuing controversies. Lancet Infect Dis. 2008;8(4):225-32. [Crossref]  [PubMed] 
  26. Cripe L, Andelfinger G, Martin LJ, Shooner K, Benson DW. Bicuspid aortic valve is heritable. J Am Coll Cardiol. 2004;44(1):138-43. [Crossref]  [PubMed] 
  27. Roberts WC, Morrow AG, McIntosh CL, Jones M, Epstein SE. Congenitally bicuspid aortic valve causing severe, pure aortic regurgitation without superimposed infective endocarditis. Analysis of 13 patients requiring aortic valve replacement. Am J Cardiol. 1981;47(2):206-9. [Crossref]  [PubMed] 
  28. Fenoglio JJ Jr, McAllister HA Jr, DeCastro CM, Davia JE, Cheitlin MD. Congenital bicuspid aortic valve after age 20. Am J Cardiol. 1977;39(2):164-9. [Crossref]  [PubMed] 

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