Evaluation of patients with bicuspid aortic valve diagnosis followed up in Trakya University Faculty of medicine Hospital pediatric cardiology clinic

In addition to the aortic valve, BAV may also affect the proximal aorta, leading to aortic dilatation and subsequent life-threatening pathologies such as aortic dissection and rupture. In this study, we aimed to compare the change in aortic elasticity and stiffness with healthy children by measuring the systolic and diastolic diameters of various regions of the aorta. We also tried to determine the pulse wave velocity using dye-based thoracic aortic length, which has not been used in patients with BAV before, and to determine the reliability of this method. A control group consisting of 63 patients with BAV who were followed up by the Department of Pediatric Cardiology, T.Ü.T.F., and who continued their regular follow-up was formed. The diameters of the annulus aorta, sinus of valsalva, sinotubular junction, ascending aorta, arch aorta and abdominal aorta at systolic and diastolic phases at the time of diagnosis and at the last follow-up were obtained from patient files. Using these measurements, distensibility, strain and stiffness (β index) values showing the stiffness and elasticity of the aorta were calculated. The same measurements were evaluated in the control group. In addition, pulse wave velocity values were calculated using the length of the thoracic aorta based on the length of the thoracic aorta in the last controls of the study group and in the control group. These values were compared with aortic distensibility, strain and stiffness (β index) values. A study group consisting of 42 (66.67%) male and 21 (33.33%) female patients with BAV, aged 5.94±4.53 years, was compared with a control group with a similar gender distribution, aged 9.15±2.09 years. The sinus valsalva (23.00 (±6.18) mm; 21.03 (±2.53) mm; p=0.22) sinotubular junction (18.47 (±5.31) mm; 16.80 (±2.17) mm; p=0.23), ascending aorta (21.74 (±6.01) mm; 19.39 (±2.56) mm; p=0.05) in the systolic phase compared to the control group. The systolic phase measurements in all regions of the patients in the study group showed a statistically significant increase when evaluated according to the time of diagnosis and the last controls. The z scores of the systolic phase measurements of all measurement sites were also higher than those of the control group. In addition, strain values in the sinotubular junction and ascending aorta regions were lower and β stiffness index was higher in the study group. The pulse wave velocity calculated using the length of the thoracic aorta based on the height of the study and control groups (3.78 (±0.92); 3.17 (±0.78); p<0.001) was significantly higher in the study group. In addition, there was a significantly strong correlation between pulse wave velocity and distensibility, strain and β stiffness index evaluated in all measurement sections. In our study, it was found that BAV caused dilatation at different levels in all regions of the aorta during the follow-up of patients diagnosed with BAV. In addition, BAV affects aortic elasticity and aortic stiffness and consequently increases the risk of aortopathy. Pulse wave velocity calculated using dye-based thoracic aortic length was evaluated for the first time in patients with BAV and is recommended in the follow-up of patients with BAV because it can be applied quickly and easily in outpatient clinic conditions. However, studies with longer duration and larger participants are needed.