Evaluation of demographic, clinical and echocardiographic findings of patients with A diagnosis of bicuspid aortic valve and investigation of changes in clinical and echocardiographic parameters during follow- UP

Evaluation of demographic, clinical and echocardiographic findings of patients with a diagnosis of bicuspid aortic valve and investigation of changes in clinical and echocardiographic parameters during follow-up. Hacettepe University Faculty of Medicine, Child Health and Diseases Thesis. Ankara 2023. Bicuspid aortic valve disease (BAV) is the most common congenital heart anomaly. BAV has been reported to cause aortic stenosis (AS) and aortic regurgitation (AR). Bicuspid aortic valve is more common in males. BAV is the most common cause of aortic valve stenosis in children and adults. Intervention options in the treatment of AS are percutaneous balloon valvoplasty (BVP), surgical aortic valvulotomy (commissurotomy), and aortic valve replacement (AVR). One of the most important findings of BAV disease is enlargement of the ascending aorta. Studies on risk factors affecting ascending aortic enlargement have been reported in the literature. In our study, we retrospectively analyzed the demographic, clinical and echocardiographic parameters of patients with bicuspid aortic valve, which has few studies in the pediatric field in our country, and aimed to compare the changes in these parameters, complications, and pre- and post-procedure conditions in the follow-up. Of the 157 patients included in the study, 107 (68.2%) were male and 50 (31.8%) were female. The mean age of the patients was 12.48±5.41/year and the mean age at which they were diagnosed was 34.04±48.88 months. The mean follow- up year was 5.64±1.61 years. Aortic stenosis developed over time in 9.8% of 82 patients without aortic stenosis. AR developed in 38.2% of 76 patients without aortic regurgitation during follow-up over time. The annual mean of the ascending aorta of the patients was 1.11±0.68 mm. According to the results of multivariate logistic regression analysis, we found increased age, less body surface area, moderate-severe AR, and right-non (RN) valve type as risk factors for ascending aortic enlargement. BVP procedure was performed in 26 patients with moderate-severe AS. Our success rate was 62%. In the long-term follow-up after BVP, 9 (35%) patients had moderate- severe AR. The re-intervention rate was 19%. Surgical valvulotomy was performed in 10 patients with moderate to severe AS during the follow-up. In the follow-up after valvulotomy, moderate-severe AR developed in 6 (60%) patients. The re- intervention rate was found to be 30%. 7 Keywords: bicuspid aortic valve, aortic stenosis, ballon valvuloplasty , valvulotomy