Aortic dilatation and calcification in asymptomatic patients with bicuspid aortic valve: Analysis in a Korean health screening population

Entire anatomic area involved in the bicuspid aortic valve (BAV) disease has not been studied well, especially in Asian populations. We investigated prevalence and vascular characteristics of the BAV disease in a Korean population. In a health screening program from 2005 through 2010, 38 BAV patients (BAV group, 0.16 %, 35 males) were isolated among a total of 23,291 persons based on echocardiography. Each BAV patient was matched with three TAV patients (TAV group, n = 114) of the same age, gender, BSA, and hypertension. Using echocardiography and low-dose chest CT scan, diameters of the aortic root to proximal descending aorta (pDA) and pulmonary artery (PA), morphologic types of BAV, and calcification in the aortic root were evaluated in both groups. Diameters of the sinotubular junction and ascending aorta in BAV group were larger than in TAV group (29 ± 7 vs. 27 ± 3 mm, p = 0.046; 42 ± 7 vs. 34 ± 4 mm, p < 0.001, respectively). Diameters of the annulus, sinus of Valsalva, aortic arch, pDA, and PA were not different between two groups. Calcification in the aortic root was approximately seven times more common in BAV group (p < 0.001). Diameters of the aortic root were larger in the R-L type (n = 24) than in the R-N type (n = 11). Prevalence of BAV in a Korean population appears lower than in Western populations. Within the entire anatomic boundaries of BAV, the ascending aorta was predominantly dilated in BAV patients. The R-L type showed more dilatation than the R-N type, not in the ascending aorta but in the aortic root.