Poster No. 129 Aortic events during pregnancy in women with bicuspid aortic valve and aortic dilatation. A retrospective study

The risk of aortic dissection during pregnancy remains poorly appreciated in women with BAV.

retrospective study using data of women seen in our center with BAV and aortic dilatation, not affected by a genetic syndrome who have been pregnant. Assuming from the literature an annual aortic dilation rate of 0.2 mm at aortic root and 0.4 mm at ascending aorta, we estimated ascending aortic diameters and Z-score at the time of pregnancy.

We identified 47 women with BAV and aortic dilatation with an occurrence of 103 pregnancies.

Age at the time of pregnancy was 29 (26–33) years. No aortic dissection occurred during pregnancy or postpartum period. At distance of pregnancy and post partum, acute aortic dissection occurred in 2 women and elective aortic surgery was performed on 8 women, associated with aortic valve replacement for 6 of them.

Age at first visit in our center was 43 (35–56) years old. Median largest ascending aortic diameter (root or tubular aorta) was 44 (40–47) mm corresponding to a median Z-score of 4.4 (3.6–5.1).

At the time of pregnancy, estimated largest aortic diameter was 37.2 (33.4–42.3) mm, ≥ 40 mm in 40/103 pregnancies, ≥ 45 mm in 15/103, and ≥ 50 mm in 0/10. Estimated Z-score was 3.4 (2.3–4.7), ≥ 2 in 86/103 and ≥ 4 in 40/103 at the time of pregnancy.

In our population of women with BAV and aortic dilatation, no aortic complication occurred during 103 pregnancies, despite high incidence of aortic dilation.