Wilson-Smith Ashley R, Eranki Aditya, Muston Benjamin, Kamalanathan Harish, Yung Amanda, Williams Michael L, Sahai Prachi, Zi Caroline, Michelena Hector
The Chris O'Brien Lifehouse Center, Sydney, Australia.
The Collaborative Research Group (CORE), Sydney, Australia.
Ann Cardiothorac Surg. 2022 Jul;11(4):363-368. doi: 10.21037/acs-2022-bav-21.
The true incidence of bicuspid valve-related aortic dissection (AD) is extremely difficult to ascertain. This review aimed to provide the reported cumulative incidence of bicuspid aortic valve (BAV)-related AD in actively monitored study populations.
Four electronic databases were used to perform literature searches. A meta-analysis of proportions or means were performed for categorical and continuous variables, as appropriate. Survival data was calculated from the aggregation of Kaplan-Meier (KM) curves from the included studies, where reported.
A total of 4,330 patients were identified in eleven studies. A cumulative incidence of bicuspid valve-related AD of 0.6% across a median follow-up time of 9 years was identified. Actuarial survival across this monitored population at 1, 3, 5 and 10 years was 97.2%, 96.7%, 92.45%, and 81.1%, respectively.
This systematic review and meta-analysis identified a low incidence of AD across the examined follow-up period. Large, prospective studies involving early identification of bicuspid valve pathology, recruitment, and follow-up of BAV cohorts with comparison to the baseline population are required to most accurately determine the outcomes of these patients.
二尖瓣相关主动脉夹层（AD）的真实发病率极难确定。本综述旨在提供在积极监测的研究人群中报告的二尖瓣主动脉瓣（BAV）相关AD的累积发病率。
使用四个电子数据库进行文献检索。对分类变量和连续变量分别进行比例或均值的荟萃分析。如有报告，生存数据通过纳入研究的Kaplan-Meier（KM）曲线汇总计算得出。
11项研究共纳入4330例患者。在中位随访时间9年期间，二尖瓣相关AD的累积发病率为0.6%。该监测人群1年、3年、5年和10年的精算生存率分别为97.2%、96.7%、92.45%和81.1%。
本系统综述和荟萃分析发现在所研究的随访期内AD发病率较低。需要开展大型前瞻性研究，早期识别二尖瓣病变，招募BAV队列并进行随访，并与基线人群进行比较，以最准确地确定这些患者的预后。
