Abstract
Background
This study focuses on two of the most prevalent congenital heart defects: bicuspid aortic valve (BAV) and coarctation of the aorta (CoA). In severe forms, CoA is an emergency that can become life-threatening. Both diseases are linked to aortic vasculopathy, which represents a significant contributor to morbidity and mortality in young patients with congenital heart disease. The aim of this study was to investigate whether there are differences between patients with CoA and BAV, and patients with CoA and without BAV in terms of outcome and echocardiographic parameters, and to evaluate the efficacy of different echocardiographic parameters in predicting CoA.
Methods
A retrospective and prospective observational analytic study was conducted between January 2018 and October 2024 at a tertiary pediatric cardiology referral center enrolling patients aged between 0 and 17 years, diagnosed with CoA, who underwent surgical CoA repair. The common carotid-subclavian artery index (CSAI) and the aortic isthmus-descending aorta index (I/D) were calculated based on echocardiographic measurements.
Results
A total of 101 patients underwent surgical or interventional treatment for CoA in the studied period, 58.4% being neonates. Based on echocardiographic examination, 68.3% of patients had BAV with CoA. The mean value of the carotid-subclavian index was 0.95 in neonates, compared to 1.11 in children (p = 0.035). No statistically significant difference was observed in the mean value of the aortic isthmus-descending aorta index between the two groups (p = 0.237).
Conclusions
The implications of the coexistence of the two conditions are not yet fully understood. This study did not find significant echocardiographic differences between patients with CoA and BAV and patients with CoA and without BAV. Further long-term, multicenter, multi-arm studies with larger groups are required in these areas.