Limitations
Due to the retrospective nature of this study, the hemodynamic data
limited to what was documented in echocardiography reports. We did not
evaluate interobserver variability by independent review of hemodynamic
parameters. As such, we were unable to account for effects of BAV
morphology (i.e. cusp fusion pattern, presence of raphe) as they were
inconsistently reported on. In addition, this was a single center study,
which limits generalizability and raises the possibility of not
capturing outside imaging and operative records, though an extensive
chart review was conducted using our electronic medical record. Lastly,
the power of statistical conclusions drawn from this sample are limited
by the sample size of the BAV cohort. Our findings warrant future
multicenter studies in order to achieve larger a sample of BAV patients.