Clinical Outcomes of Adults With Bicuspid Aortic Valve: A European Perspective

International audienceObjective: To describe the clinical history of patients with a wide age range diagnosed with bicuspid aortic valve (BAV) and no surgical indication and to evaluate the long-term outcome of patients with BAV referred for elective surgery. Patients and Methods: Between 2005 and 2017, 350 consecutive patients with no surgical indication (surveillance group, mean age 53 +/- 16, 71% men) and 191 with a surgical indication (surgical group, mean age 59 +/- 13, 71% men) were prospectively included. Median follow-up was 80 (32 to 115) months. Results: In the surveillance group, the 5-year and 10-year survival rates were 93 +/- 1% and 89 +/- 2%, respectively, with a relative survival of patients with BAV compared with an age- and sex-matched control population of 98.7%. During follow-up, the cumulative 10-year incidence of aortic valve and aorta surgery was high; of 35 +/- 4%, the incidence of native valve infective endocarditis (IE) of 0.2% per patient-year, and no cases of aortic dissection were observed. In the surgical group, the 5-year and 10-year survival rates were 97 +/- 1% and 89 +/- 3%, respectively, with a relative survival of 99.4% compared with the general population. The incidence of IE was 0.4% per patient-year, and no cases of aortic dissection were observed. Conclusion: This regional cohort shows that the 10-year survival rates of patients with BAV and a wide age range, but mostly middle-aged adults, were similar to those of the general population with a very low rate of complications. Adherence to prophylactic surgical indications and younger age might have contributed to this lack of difference. (C) 2020 Mayo Foundation for Medical Education and Researc