Key result
Pooled echocardiography data shows BAV prevalence is ~0.6%, lower than frequently reported historical estimates.
Why the study?
BAV prevalence is frequently cited as 1-2% based on older autopsy studies, whereas contemporaneous echocardiography screening studies report lower prevalence without autopsy selection bias.
What is the prevalence of bicuspid aortic valve in the general population based on autopsy and echocardiography studies?
Meta-Analysis (n=341,875)
What is the prevalence of bicuspid aortic valve in the general population based on autopsy and echocardiography studies?
Absolute Event Rate: 0.81% vs 0.61%
p-value: p=<0.001
The prevalence of bicuspid aortic valve is 0.61-0.81%, which is lower than the frequently reported 1-2%, supporting the cost-effectiveness of screening first-degree relatives.
Supports cost-effective screening of first-degree relatives; challenges the 1-2% prevalence in prior literature.
Bicuspid aortic valve (BAV) is frequently reported as the most common congenital cardiac condition, with 1-2% prevalence by citing one or two autopsy studies performed up to forty years ago. Since then, echocardiography population screening studies have reported contemporaneous results, with lower prevalence, given the absence of autopsy selection bias. Therefore, we performed a systematic review and meta-analysis of autopsy and echocardiography studies to provide a more accurate synthesis of BAV prevalence. Following a systematic literature review, we performed a meta-analysis of prevalence studies using MetaXL Software Version 5.3 by EpiGear, St Lucia, Australia. The results of 45,630 autopsy patients reveal a prevalence of 0.81% (0.5-1.2%, p<0.001, n=444) and 296,245 echocardiography screened population of 0.61% (0.39-0.82% p<0.001, n=1,392) BAV prevalence. The average prevalence of 0.61-0.81% between the two studies still shows this is a common congenital cardiac condition, but shows it is less than frequently reported and thus robustly supports the case of cost effectiveness in screening first degree relatives.
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Lester et al. (2023) conducted a meta-analysis in Bicuspid Aortic Valve (n=341,875). Autopsy vs. Echocardiography was evaluated on Prevalence of Bicuspid Aortic Valve (p=<0.001). The pooled prevalence of bicuspid aortic valve was 0.81% in autopsy studies and 0.61% in echocardiography screening studies, which is lower than the frequently reported 1-2%.
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