Clinical Outcome, Valve Dysfunction, and Progressive Aortic Dilation in a Pediatric Population With Isolated Bicuspid Aortic Valve
| Autor: | Enrico Chiappa, Pollini I, Piercarlo Ballo, Alfredo Zuppiroli, Gaia Spaziani, Silvia Favilli, Veronica Fibbi, Lorenzo Buonincontri |
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| Rok vydání: | 2013 |
| Předmět: |
Heart Defects
Congenital Male Aortic valve medicine.medical_specialty Aortic Valve Insufficiency Heart Valve Diseases Bicuspid aortic valve Bicuspid Aortic Valve Disease Risk Factors medicine.artery Internal medicine Ascending aorta medicine Clinical endpoint Humans Prospective Studies Child Prospective cohort study business.industry Aortic Valve Stenosis Prognosis medicine.disease Surgery Cardiac surgery Stenosis medicine.anatomical_structure Echocardiography Aortic Valve Child Preschool Infective endocarditis Pediatrics Perinatology and Child Health Disease Progression cardiovascular system Cardiology Female Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | Pediatric Cardiology. 35:803-809 |
| ISSN: | 1432-1971 0172-0643 |
| Popis: | The aim of this study was to explore the medium-term clinical outcome and the risk of progression of aortic valve disease and aortic dilation in pediatric patients with isolated bicuspid aortic valve (BAV). 179 pediatric patients with isolated BAV were prospectively followed from January 1995 to December 2010. Patients with severe valve dysfunction at baseline were excluded. Clinical outcome included cardiac death, infective endocarditis, aortic complications, cardiac surgery and percutaneous valvuloplasty. Echocardiographic endpoints were: progression of aortic stenosis (AS) or regurgitation (AR) and progressive aortic enlargement at different levels of the aortic root, evaluated as z-score. The median age at diagnosis was 7.8 [2.7-12.0] years. After a median followup of 5.4 [2.3-9.2] years, all patients were alive. The clinical endpoint occurred in 4 (2.2 %) patients (0.41 events per 100 patient-years). A progression of AS and AR was observed in 9 (5.0 %) and 29 (16.2 %) patients, respectively. The z-scores at the end of follow-up were not significantly different from baseline at the annulus, Valsalva sinuses and sinotubular junction, whereas a slight increase was observed at the level of the ascending aorta (1.9 vs 1.5, p = 0.046). Significant progressive aortic dilation occurred in a minority of patients (10.6, 5.6, 9.5, and 19.0 % respectively). The clinical outcome in pediatric patients with isolated BAV is favourable and the progression of aortic valve dysfunction and aortic dilation is relatively slow. These findings may be taken into account to better guide risk assessment and clinical follow-up in these patients. |
| Databáze: | OpenAIRE |
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