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February 6, 2026European Heart Journal0 citations

Characteristics and long-term outcomes of patients with bicuspid aortic valve results from a comprehensive aortic valve registry

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JAJ AwesatYAY AvivMAMerry Abitbol

Key Result

In a cohort of 2,188 patients with bicuspid aortic valve followed for a median of 12 years, overall mortality was 20.8% and 19.6% underwent surgical or transcatheter aortic valve interventions.

Key Points

  • To characterize the bicuspid aortic valve population and evaluate long-term outcomes in a large cohort.
  • Conducted a retrospective cohort analysis of patients diagnosed with BAV using echocardiography.
  • Included 2,188 patients diagnosed between 1995 and 2020.
  • Assessed the incidence of ischemic heart disease, cerebrovascular events, and aortic valve conditions.
  • Overall mortality rate was 20.8% during a median follow-up of 12 years.
  • Ischemic heart disease was present in 12.8% and cerebrovascular events in 8% of patients.
  • 14.7% had aortic stenosis and 7.5% had aortic regurgitation.
  • 19.6% of patients underwent surgical or TAVI interventions, with a significant number receiving bioprosthetic or mechanical valve replacements.

Study Design

Type

Cohort (n=2,188)

Multicenter

No

Structured PICO

P
Population
2,188 patients with bicuspid aortic valve diagnosed by echocardiography, followed for a median of 12 years.
O
Outcome
Long-term outcomes including overall mortality, need for surgical or transcatheter aortic valve interventions, aortic surgery, and infective endocarditishard clinical

Patients with bicuspid aortic valves face a high long-term burden of disease, with nearly 20% requiring surgical or transcatheter intervention over a median 12-year follow-up.

Abstract

Abstract Introduction Bicuspid aortic valve (BAV) is the most common congenital heart valve disease, presenting across a broad spectrum that ranges from non-dysfunctional valves to severe aortic stenosis (AS) and/or aortic regurgitation (AR). However, long-term outcome in a large cohort remains scarce. Objective This study aims to characterize the bicuspid aortic valve (BAV) population and evaluate outcomes in a large, single-center cohort of consecutive patients diagnosed with BAV between 1995 and 2020. Methods A retrospective cohort of consecutive patients diagnosed with BAV using echocardiography was included. Results A total of 2,188 patients (49 ± 17.1 years, male 71.6%) were included in the study. Ischemic heart disease was observed in 12.8% of patients, while 8% had a history of cerebrovascular events. AS was identified in 14.7% of patients, AR in 7.5%, and combined severe AS and AR in 1.3%. During a median follow-up time of 12 (interquartile range 10, range 0-29) years, the overall mortality rate was 20.8%, with a mean age at death of 80.6 ± 14.3 years. A total of 19.6% of patients underwent either surgical or transcatheter aortic valve interventions (TAVI). Among them, 16.8% underwent surgical procedures, including bioprosthetic valve replacement (11.2%), mechanical valve replacement (5.6%), aortic valve repair or Ross procedure (0.8%), and TAVI (1.7%),in addition, 134 (6.1%) patients also underwent aortic surgery . The incidence of infective endocarditis in the cohort was 3.6%. Conclusions BAV Registry highlights a high burden of aortic valve disease requiring surgical or transcatheter intervention , emphasizing the importance of early diagnosis.

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Cite This Study

Awesat et al. (2025) conducted a cohort in Bicuspid aortic valve (n=2,188). Bicuspid aortic valve was evaluated on overall mortality. In a cohort of 2,188 patients with bicuspid aortic valve followed for a median of 12 years, overall mortality was 20.8% and 19.6% underwent surgical or transcatheter aortic valve interventions.

synapsesocial.com/papers/698586ad8f7c464f2300a634https://doi.org/10.1093/eurheartj/ehaf784.2294
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