Screening for intracranial aneurysms in patients with bicuspid aortic valve.
OBJECTIVE
Bicuspid aortic valve (BAV) is a common congenital heart defect affecting half to 2% of the population. A generalized connective tissue disorder also involving the intracranial arteries has been suspected in this patient population. We therefore screened a group of patients with BAV for the presence of intracranial aneurysms.


METHODS
Magnetic resonance angiography or CT angiography of the brain was used in 61 patients with BAV (age, 29-70 years [mean 48 years]) and in 291 controls (28-78 years [mean 56 years]).


RESULTS
Intracranial aneurysms were detected in 6 of 61 patients with BAV (9.8%; 95% confidence interval [CI] 2.4%-17.3%). This was significantly higher than in the control population (3/291 [1.1%; 95% CI 0%-2.2%]) (p = 0.0012). Female sex (p = 0.02) and advanced age (p = 0.003), risk factors for intracranial aneurysm development, were more common in the control population than among the patients with a BAV. No significant differences were detected in age, sex, smoking, arterial hypertension, alcohol use, aortic diameter, or frequency of aortic coarctation between BAV patients with and without intracranial aneurysms.


CONCLUSIONS
In this case-control study, the frequency of intracranial aneurysms among our bicuspid aortic valve patient population was significantly higher than in the control population.
Schievink
Wouter I
WI
Department of Neurosurgery, Cedars-Sinai Medical Center, 8631 Third Street, Suite 800E, Los Angeles, CA 90048, USA. SchievinkW@cshs.org
Raissi
Sharo S
SS
Maya
M Marcel
MM
Velebir
Arlys
A
D000328:Adult; D000368:Aged; D001021:Aortic Valve / Q000002:abnormalities*; D016022:Case-Control Studies; D002560:Cerebrovascular Circulation; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications*; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis / Q000209:etiology; D008297:Male; D008875:Middle Aged