Long-term performance of bicuspid and quadricuspid aortic valves: Similarities and differences.

Abstract

Evaluation of long-term performance, similarities, and differences between QAV and BAV. Screening of 19000 consecutive echocardiographic studies was performed. BAV was reported in 131 subjects with a prevalence of 0.7%, while QAV was seen in 11 with a prevalence of 0.06%, P<.00001. Age of BAV patients was younger, 45±20years vs 62±17years in QAV, P<.05, with higher proportion of females in those with QAV, 40% vs 30%. Chamber diameters were similar in both groups. Higher atrial contraction-A-wave mitral peak velocities and longer E-wave deceleration times were found in subjects with QAV, P<.05 for both. Dilated ascending aorta was found in 25% of patients with BAV and in 18% of those with QAV, P=.2. Moderate and severe aortic valve stenosis were found in 21% of patients with BAV and in 27% of those with QAV, P=ns. More than moderate aortic regurgitation was found in 15.5% of BAV patients and in 9% of QAV, P=ns. Aortic valve infective endocarditis was found in 1.5% of BAV patients and in 9% of those with QAV. BAV is a common congenital anomaly, while QAV is rare. Similar prevalence of significant valve disease and aortopathy was found in both anomalies, though at younger age in BAV patients.