Aortic Valve Dysfunction and Aortic Dilation in Adults with Coarctation of the Aorta. (14th June 2013)

• Record Type: Journal Article
• Authors: Clair, Mathieu; Fernandes, Susan M.; Khairy, Paul; Graham, Dionne A.; Krieger, Eric V.; Opotowsky, Alexander R.; Singh, Michael N.; Colan, Steven D.; Meijboom, Erik J.; Landzberg, Michael J.
• Is Part Of: Congenital heart disease. Volume 9:Number 3(2014)
• Page Start: 235
• Page End: 243
• Publication Date: 2013-06-14
• Subjects: Congenital heart disease -- Periodicals; 616.1204305
• DOI: 10.1111/chd.12109
• Languages: English
• ISSNs: 1747-079X

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="chd12109-sec-0001" sec-type="section"> <title>Objectives</title> <p>To determine the prevalence of aortic valve dysfunction, aortic dilation, and aortic valve and ascending aortic intervention in adults with coarctation of the aorta (CoA).</p> </sec> <sec id="chd12109-sec-0002" sec-type="section"> <title>Background</title> <p>Aortic valve dysfunction and aortic dilation are rare among children and adolescents with CoA. With longer follow‐up, adults may be more likely to have progressive disease.</p> </sec> <sec id="chd12109-sec-0003" sec-type="section"> <title>Methods</title> <p>We retrospectively reviewed all adults with CoA, repaired or unrepaired, seen at our center between 2004 and 2010.</p> </sec> <sec id="chd12109-sec-0004" sec-type="section"> <title>Results</title> <p>Two hundred sixteen adults (56.0% male) with CoA were identified. Median age at last evaluation was 28.3 (range 18.0 to 75.3) years. Bicuspid aortic valve (BAV) was present in 65.7%. At last follow‐up, 3.2% had moderate or severe aortic stenosis, and 3.7% had moderate or severe aortic regurgitation. Dilation of the aortic root or ascending aorta was present in 28.0% and 41.6% of patients, respectively. Moderate or severe aortic root or ascending aortic dilation (<italic>z</italic>‐score > 4) was present in 8.2% and 13.7%, respectively. Patients with BAV were more likely to have moderate or severe ascending aortic dilation compared with those without BAV (19.5% vs. 0%; <italic>P</italic> < 0.001). Age was associated with ascending aortic dilation (<italic>P</italic> = 0.04). At most recent follow‐up, 5.6% had undergone aortic valve intervention, and 3.2% had aortic root or ascending aortic replacement.</p> </sec> <sec id="chd12109-sec-0005" sec-type="section"> <title>Conclusion</title> <p>In adults with CoA, significant aortic valve dysfunction and interventions during early adulthood were uncommon. However, aortic dilation was prevalent, especially of the ascending aorta, in patients with BAV.</p> </sec> </abstract>