Pregnancy and congenitally bicuspid aortic valve (BAV) are thought to be risk factors
for aortic dissection; however, the population-based risk for patients with the 2
risk factors remains unknown. We investigated the relation between pregnancy and ascending
aortic events in women with congenital BAV living in Olmsted County, Minnesota. Our
institutional echocardiographic database was searched for women residing in Olmsted
County with congenital BAV diagnosed from 1980 to 1999. We reviewed medical records
for end points of aortic events (dilatation, dissection, or surgery) and aortic valve
replacement (AVR). Obstetric history and further outcome follow-up were collected
by postal survey. We identified 88 women with BAV. Median age at diagnosis was 35
years. Obstetric history totaled 216 pregnancies and 186 deliveries. There were no
aortic dissections. During follow-up (median 12.3 years), 24 patients underwent AVR
(n = 14), ascending aortic surgery (n = 3), or AVR and ascending aortic surgery (n
= 7). Pregnancy was not associated with dilatation of the aorta, aorta surgery, or
AVR. At echocardiographic diagnosis of BAV, 5 patients (6%) had aortas >40 mm in greatest
diameter and 1 patient has >50 mm. Of 60 patients with serial echocardiograms for
comparison (median interval 10.7 years), 21 patients (35%) had aortas measuring >40
mm in greatest dimension and 2 patients had >50 mm. In conclusion, aortic dissection
in women with BAV and pregnancy is rare in the community. There is a significant rate
of progressive enlargement of the aorta, warranting longitudinal follow-up.
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Article Info
Publication History
Accepted:
August 17,
2010
Received in revised form:
August 17,
2010
Received:
March 27,
2010
Identification
Copyright
© 2011 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
