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. 2022 Jul;11(4):363-368.
doi: 10.21037/acs-2022-bav-21.

Incidence of bicuspid valve related aortic dissection: a systematic review and meta-analysis

Ashley R Wilson-Smith  1   2   3   4 , Aditya Eranki  3 , Benjamin Muston  2   5 , Harish Kamalanathan  3 , Amanda Yung  2   6 , Michael L Williams  2   6 , Prachi Sahai  3 , Caroline Zi  5 , Hector Michelena  5
Affiliations

Incidence of bicuspid valve related aortic dissection: a systematic review and meta-analysis

Ashley R Wilson-Smith et al. Ann Cardiothorac Surg. 2022 Jul.

Abstract

Background: The true incidence of bicuspid valve-related aortic dissection (AD) is extremely difficult to ascertain. This review aimed to provide the reported cumulative incidence of bicuspid aortic valve (BAV)-related AD in actively monitored study populations.

Methods: Four electronic databases were used to perform literature searches. A meta-analysis of proportions or means were performed for categorical and continuous variables, as appropriate. Survival data was calculated from the aggregation of Kaplan-Meier (KM) curves from the included studies, where reported.

Results: A total of 4,330 patients were identified in eleven studies. A cumulative incidence of bicuspid valve-related AD of 0.6% across a median follow-up time of 9 years was identified. Actuarial survival across this monitored population at 1, 3, 5 and 10 years was 97.2%, 96.7%, 92.45%, and 81.1%, respectively.

Conclusions: This systematic review and meta-analysis identified a low incidence of AD across the examined follow-up period. Large, prospective studies involving early identification of bicuspid valve pathology, recruitment, and follow-up of BAV cohorts with comparison to the baseline population are required to most accurately determine the outcomes of these patients.

Keywords: Bicuspid aortic valve (BAV); aortic dissection (AD); cumulative incidence.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Actuarial survival in bicuspid aortic valve patients with number at risk (failure events).
See this image and copyright information in PMC

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