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Background: There are limited data regarding intracranial aneurysm (IA) in patients with bicuspid aortic valve (BAV).
Methods: Retrospective review of patients with BAV who underwent brain magnetic resonance angiography (MRA) at Mayo Clinic, 1994-2013. Study objective was to determine the prevalence and outcomes of IAs.
Results: There were 678 patients included in this study, mean age 57±13 years; males 480 (71%); mean follow-up 10±3 years (5,913 patient-years). Coarctation of aorta (COA) was present in 154 (23%) patients.
There were 59 IAs identified in 52 of 678 patients (7.7%). IA was present in 20/154 patients (12.9%) with COA and 32/524 patients (5.7%) without COA. P<0.001. For the patients without COA, the risk factors for IA were male gender (HR 1.81, CI 1.35=4.64, P=.03), and right-left cusp fusion (HR 2.17, CI 1.66-2.95, P=.01). Among those without COA, there were 53 females with right-left cusp fusion, and 6 of them had IA yielding a prevalence of 11.3% (9.3-13.5), which was similar to a prevalence of 12.9% (11.5-13.8) in the patients with COA, P=.21.
Among the 52 patients with IA, enlargement occurred in 3 (6%), rupture in 2 (4%), and 4 patients (8%) underwent coil embolization. For the 626 patients without IA at baseline, no patient developed IA over 7±2 years of imaging follow-up.
Conclusions: The prevalence of IA in patients with BAV was 7.7%. BAV patients without COA have a 3 fold increased risk of IA compared to the general population; and this risk is highest in females with right-left cusp fusion. Based on this retrospective review, a baseline screening brain MRA is reasonable in BAV patients, especially women with right and left cusp fusion. These data also support additional prospective review of this question.
Moderated Poster Contributions
Vascular Medicine Moderated Poster Theater, Poster Hall, Hall C
Saturday, March 18, 2017, 4:15 p.m.-4:25 p.m.
Session Title: Advancing Our Understanding of Aortic Disease
Abstract Category: 40. Vascular Medicine: Non Coronary Arterial Disease
Presentation Number: 1267M-07
- 2017 American College of Cardiology Foundation