How important is a bicuspid aortic valve?

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Bicuspid aortic valve is the most common congenital anomaly in children, with a prevalence of 1% or more in the general population. It usually has been considered to be a relatively unimportant defect, but good epidemiologic data have been lacking. In this issue of the Journal, Mahle et al review information from a large single institutional cohort with isolated bicuspid aortic valve. They found a low incidence of adverse cardiac events. Patients with bicuspid aortic valve may develop mild ascending aortic dilation, but this was not clinically important, and aortic dissection did not occur. However, it is not known if aortic dilation could be progressive with aging in some patients. Longer term follow up is required.

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