Prevalence of Bicuspid Aortic Valve: Systematic Review and Meta-Analysis of Prevalence Studies

Abstract

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.