2010, Number 1
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Rev Invest Clin 2010; 62 (1)
Bicuspid aortic valve: a synergistic factor for aortic dilation and dissection in Marfan syndrome?
Amezcua-Guerra L, Santiago C, Espínola-Zavaleta N, Pineda C
Language: English
References: 13
Page: 39-43
PDF size: 52.72 Kb.
ABSTRACT
Patients with either Marfan syndrome or bicuspid aortic valve
are at increased risk for aortic dilation and dissection, but occurrence
of both conditions has barely been reported. Whether
bicuspid aortic valve adversely impacts the cardiovascular
outcome in Marfan syndrome patients is unknown. The objective
was to investigate the prevalence of bicuspid aortic valve
and to define whether its combined presence would adversely
impact cardiovascular outcome in patients with Marfan syndrome.
We performed a retrospective review on a Marfan syndrome
database from a single center. Comparisons between
patients with or without bicuspid aortic valve were performed
by χ
2 or Student t test as appropriate. Bicuspid aortic valve
was found in 4 of 89 Marfan syndrome patients (two males;
mean age 21.5 ± 13 years) for 4.5% prevalence; in contrast,
1.5% prevalence was found in 200 control subjects (p = 0.1).
Each patient with bicuspid aortic valve is separately discussed.
Presence of bicuspid aortic valve shows trends for association
with aortic dilation (Odds ratio [OR] 4.2; 95% Confidence interval
[95%CI] 0.2-81), and aortic dissection (OR 5.5; 95%CI
0.7-42), while negative association with the Walker-Murdoch
sign (OR 0.07; 95%CI 0.006-0.73) was found. Prevalence of bicuspid
aortic valve in patients with Marfan syndrome patients
is 4.5%. While it is intriguing and even intuitive that the concurrence
of both conditions would lead to more aggressive
aortic disease, a true synergistic role for aortic wall weakening
cannot be supported.
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