Abstract:
Bicuspid aortic valve (BAV) is the most common congenital heart defect. It can be accompanied by aortic regurgitation or stenosis with aortopathies. Studies in adults showed a sex difference, but there are limited number of reports in the pediatric population. To evaluate the difference in bicuspid aortic valve morphology and functionality between sexes, and the presence and progression of aortopathies, a retrospective chart review study was performed at a tertiary referral care center in the Midwest. In our study, we analyzed a cohort of 476 pediatric patients diagnosed with BAV who presented between January 2007 and February 2018. During the follow-up period spanning 2 to 10 years, male patients (n = 314, 66%) had larger aortic valve annulus (AVA) and sinus of Valsalva (SOV) at the time of initial presentation with more likelihood for progression. In the subgroup analysis, the larger SOV in males was observed in isolated BAV patients without genetic syndromes or cardiac malformations, and there were no significant differences between both sexes in the ascending aorta dimension, valve functionality, valve morphology, and the need for intervention in any of the studied groups. As such, these findings may alter the follow-up focus and frequency for patients with BAV, particularly before adulthood, and warrant further studies.
摘要:
二叶主动脉瓣(BAV)是最常见的先天性心脏病。可伴有主动脉返流或狭窄伴主动脉病变。对成年人的研究显示了性别差异,但是儿科人群的报告数量有限。评价两性二叶主动脉瓣形态和功能的差异,以及主动脉病变的存在和进展,在中西部的三级转诊护理中心进行了一项回顾性图表回顾研究.在我们的研究中,我们分析了2007年1月至2018年2月期间诊断为BAV的476例儿科患者的队列.在为期2至10年的随访期间,男性患者(n=314,66%)在初次就诊时主动脉瓣环(AVA)和Valsalva窦(SOV)较大,进展可能性较大.在亚组分析中,在没有遗传综合征或心脏畸形的孤立BAV患者中观察到男性中较大的SOV,男女在升主动脉尺寸上没有显着差异,阀门功能,瓣膜形态,以及对任何研究组进行干预的必要性。因此,这些发现可能会改变BAV患者的随访重点和频率,特别是在成年之前,并值得进一步研究。