Characterization and risk factors for aortic dilatation in pediatric patients with bicuspid aortic valve

Anna Sabaté-Rotés, Laura Sabidó Sanchez, Ferran Gran Ipiña, Dimpna Albert Brotons, Raúl F. Abella, Ferran Rosés Noguer

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© 2017 Elsevier España, S.L.U. Introduction and objectives Dilatation of the ascending aorta associated with bicuspid aortic valve is a major cause of morbidity and mortality in adults. The main objective was to recognize the aortic involvement in children, its characteristics and risk factors. Methods Aortic measures of all pediatric patients with bicuspid aortic valve followed in a tertiary pediatric hospital between 1997 and 2015 were retrospectively taken. Patients with syndromes associated with aortic dilatation were excluded (n = 17). Results Two hundred and six patients were included, 67.9% males. The commonest opening pattern was horizontal: 137 (66.7%). Half of the patients (101) had a history of surgical aortic coarctation, 46 (22.3%) had ≥ moderate aortic valve stenosis and 13 (6%) had ≥ moderate aortic insufficiency. Mean follow-up time was 6.1 (4.9) years; diagnosis of aortic dilatation was made during the first year of follow-up. Progression of the dilatation of the ascending aorta was noted in 17.1%, and of the aortic root in 2.5%. More than one-third (80/206) had aortic dilatation (z-score > 2). The ascending aorta was exclusively affected in 70/80 patients, with sparing of the aortic root. In the multivariate analysis, patients with dilatation of the ascending aorta were associated with absence of coarctation (P =.001) and vertical opening pattern (P =.007). Conclusions Pediatric patients with bicuspid aortic valve warrant medical follow-up for the frequent association with valve impairment and/or dilatation of the ascending aorta.
Original languageEnglish
Pages (from-to)391-396
JournalMedicina Clinica
Issue number9
Publication statusPublished - 9 Nov 2017


  • Aortic aneurysm
  • Bicuspid aortic valve
  • Congenital heart disease
  • Dilatation
  • Pediatrics
  • Sinus of Valsalva


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