Variability in surveillance practice for patients with diagnosis of bicuspid aortic valve syndrome
Abstract In patients with bicuspid aortic valves, guidelines call for regular follow-up to monitor disease progression and guide intervention. We aimed to evaluate how closely these recommendations are followed at a tertiary care center. Among 48,504 patients who received echocardiograms (2013–2018)...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2022-12-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-022-25571-x |
| _version_ | 1797977466025803776 |
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| author | Arianna M. Kahler-Quesada Ishani Vallabhajosyula Sameh Yousef Makoto Mori Andrea Amabile Roland Assi Arnar Geirsson Prashanth Vallabhajosyula |
| author_facet | Arianna M. Kahler-Quesada Ishani Vallabhajosyula Sameh Yousef Makoto Mori Andrea Amabile Roland Assi Arnar Geirsson Prashanth Vallabhajosyula |
| author_sort | Arianna M. Kahler-Quesada |
| collection | DOAJ |
| description | Abstract In patients with bicuspid aortic valves, guidelines call for regular follow-up to monitor disease progression and guide intervention. We aimed to evaluate how closely these recommendations are followed at a tertiary care center. Among 48,504 patients who received echocardiograms (2013–2018) at a tertiary care center, 245 patients were identified to have bicuspid aortic valve. Bivariate analyses compared characteristics between patients who did and did not receive follow-up by a cardiovascular specialist. During a median follow-up of 3.5 ± 2.2 years (mean age 55.2 ± 15.6 years, 30.2% female), 72.7% of patients had at least one visit with a cardiovascular specialist after diagnosis of bicuspid aortic valve. These patients had a higher proportion of surveillance by echocardiogram (78.7% vs. 34.3%, p < .0001), CT or MRI (41.0% vs. 3.0%, p < .0001), and were more likely to undergo surgery. Patients with moderate-severe valvular or aortic pathology were not more likely to be followed by a specialist or receive follow-up echocardiograms. Follow-up care for patients with bicuspid aortic valve was highly variable, and surveillance imaging was sparse despite guidelines. There is an urgent need for mechanisms to monitor this population with increased risk of progressive valvulopathy and aortopathy. |
| first_indexed | 2024-04-11T05:07:21Z |
| format | Article |
| id | doaj.art-50d138ae187740dab02f1ba413616f05 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-04-11T05:07:21Z |
| publishDate | 2022-12-01 |
| publisher | Nature Portfolio |
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| series | Scientific Reports |
| spelling | doaj.art-50d138ae187740dab02f1ba413616f052022-12-25T12:13:18ZengNature PortfolioScientific Reports2045-23222022-12-011211710.1038/s41598-022-25571-xVariability in surveillance practice for patients with diagnosis of bicuspid aortic valve syndromeArianna M. Kahler-Quesada0Ishani Vallabhajosyula1Sameh Yousef2Makoto Mori3Andrea Amabile4Roland Assi5Arnar Geirsson6Prashanth Vallabhajosyula7Division of Cardiac Surgery, Yale Aortic Institute, Yale University School of MedicineDivision of Cardiac Surgery, Yale Aortic Institute, Yale University School of MedicineDivision of Cardiac Surgery, Yale Aortic Institute, Yale University School of MedicineDivision of Cardiac Surgery, Yale Aortic Institute, Yale University School of MedicineDivision of Cardiac Surgery, Yale Aortic Institute, Yale University School of MedicineDivision of Cardiac Surgery, Yale Aortic Institute, Yale University School of MedicineDivision of Cardiac Surgery, Yale Aortic Institute, Yale University School of MedicineDivision of Cardiac Surgery, Yale Aortic Institute, Yale University School of MedicineAbstract In patients with bicuspid aortic valves, guidelines call for regular follow-up to monitor disease progression and guide intervention. We aimed to evaluate how closely these recommendations are followed at a tertiary care center. Among 48,504 patients who received echocardiograms (2013–2018) at a tertiary care center, 245 patients were identified to have bicuspid aortic valve. Bivariate analyses compared characteristics between patients who did and did not receive follow-up by a cardiovascular specialist. During a median follow-up of 3.5 ± 2.2 years (mean age 55.2 ± 15.6 years, 30.2% female), 72.7% of patients had at least one visit with a cardiovascular specialist after diagnosis of bicuspid aortic valve. These patients had a higher proportion of surveillance by echocardiogram (78.7% vs. 34.3%, p < .0001), CT or MRI (41.0% vs. 3.0%, p < .0001), and were more likely to undergo surgery. Patients with moderate-severe valvular or aortic pathology were not more likely to be followed by a specialist or receive follow-up echocardiograms. Follow-up care for patients with bicuspid aortic valve was highly variable, and surveillance imaging was sparse despite guidelines. There is an urgent need for mechanisms to monitor this population with increased risk of progressive valvulopathy and aortopathy.https://doi.org/10.1038/s41598-022-25571-x |
| spellingShingle | Arianna M. Kahler-Quesada Ishani Vallabhajosyula Sameh Yousef Makoto Mori Andrea Amabile Roland Assi Arnar Geirsson Prashanth Vallabhajosyula Variability in surveillance practice for patients with diagnosis of bicuspid aortic valve syndrome Scientific Reports |
| title | Variability in surveillance practice for patients with diagnosis of bicuspid aortic valve syndrome |
| title_full | Variability in surveillance practice for patients with diagnosis of bicuspid aortic valve syndrome |
| title_fullStr | Variability in surveillance practice for patients with diagnosis of bicuspid aortic valve syndrome |
| title_full_unstemmed | Variability in surveillance practice for patients with diagnosis of bicuspid aortic valve syndrome |
| title_short | Variability in surveillance practice for patients with diagnosis of bicuspid aortic valve syndrome |
| title_sort | variability in surveillance practice for patients with diagnosis of bicuspid aortic valve syndrome |
| url | https://doi.org/10.1038/s41598-022-25571-x |
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